Growth, clinical and neurodevelopmental outcomes at school age are similar for children who received 1-year lamivudine or lopinavir/ritonavir HIV prophylaxis in early life.

Cournil A

Nagot N(#)(1), Singata-Madliki M(#)(2), Cournil A(3), Nalugya J(4), Tassembedo S(5), Quillet C(3), Tonga MW(6), Tumwine J(4), Meda N(5), Kankasa C(6), Mwiya M(6), Bangirana P(4), Peries M(3), Batting J(2), Engebretsen IMS(7), Tylleskär T(7), Perre PV(3), Ndeezi G(4), Molès JP(3).
Author information:
(1)Pathogenesis and Control of Chronic and Emerging Infections, INSERM U1058, Université de Montpellier, Etablissement Français du Sang, Université des Antilles, 60, rue de Navacelles, 34394, Montpellier Cedex, France. [Email]
(2)University of Fort Hare, East London, South Africa.
(3)Pathogenesis and Control of Chronic and Emerging Infections, INSERM U1058, Université de Montpellier, Etablissement Français du Sang, Université des Antilles, 60, rue de Navacelles, 34394, Montpellier Cedex, France.
(4)School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
(5)Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
(6)Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
(7)Centre for International Health, University of Bergen, Bergen, Norway.
(#)Contributed equally

https://dx.doi.org/10.1038/s41598-021-82762-8

In the ANRS 12174 trial, HIV-exposed uninfected African neonates who received lopinavir-ritonavir (LPV/r) prophylaxis for 1 year exhibited slower growth from birth to week 50 compared with those receiving lamivudine (3TC). We assessed whether this difference in growth persisted over time, and was accompanied by differences in neuropsychological and clinical outcomes. Between February 2017 and February 2018, we conducted a cross-sectional clinical evaluation among former trial participants who completed the 50-week follow-up and who were not HIV-infected. In addition to clinical examination, neuropsychological outcomes were assessed using the tests Kaufman-ABCII, Test of Variables of Attention, Movement Assessment Battery for Children and the Strengths and Difficulties questionnaire, parent version. Of 1101 eligible children, aged 5-7 years, 553 could be traced and analysed (274 in the LPV/r and 279 in the 3TC groups). Growth, clinical and neuropsychological outcomes did not differ between treatment groups. At school age, children exposed to LPV/r and 3TC at birth for 1 year had comparable growth and neuropsychological outcomes without evidence of long-term side-effects of LPV/r. It provides reassuring data on clinical outcomes for all HIV-infected children treated with this antiretroviral drug in early life.