Use of Antiretrovirals to Prevent Vertical HIV Transmission Associated With Higher Risk of Febrile Seizures in Children
Children who were exposed to antiretroviral drugs in either the prepartum, peripartum or postpartum period to reduce their odds of contracting HIV from their mothers are twice as likely as other children to suffer from febrile seizures during early childhood, according to a French study appearing in the Feb. 16 issue of the Lancet. Researchers from the French Perinatal Cohort Study Group, an ongoing nationwide epidemiological survey of vertical HIV transmission risk and prevention, analyzed the medical records of 4,426 children born to HIV-positive mothers at least 18 months before February 2001 and found that children who had received any form of antiretroviral therapy either before, during or after birth were twice as likely as other children to suffer from febrile seizures -- isolated seizures associated with fevers after three months of age -- before the age of 18 months. Of the children studied, 4,072 were HIV-negative and 354 had undetermined HIV status. The majority of the children (2,644) had received antiretroviral therapy at some point, while the remainder were largely born before the drugs were used to prevent vertical transmission. Overall, 30 children, 24 of whom had received antiretroviral therapy, recorded febrile seizures. There was no significant difference in seizure risk associated with the type of antiretroviral drugs the children had received (Landreau-Mascaro et al., Lancet, 2/16).
Risk Not Great Enough to Cease Therapy
Despite the raised risk of febrile seizures, the researchers cautioned that the seizures do not pose a large risk to the child and encouraged HIV-positive women to continue seeking intervention to prevent transmission of the virus to their infants. "Preventive treatment during pregnancy is one of the most beautiful success stories of (HIV) therapy. There is no question about that," researcher Dr. Stephane Blanche told Reuters Health in an interview. Blanche added that febrile seizures are
"well-tolerated," occur only once in most cases and should not be cause for too much concern. However, the group is conducting further research into the possibility that children who were exposed to antiretroviral drugs may experience problems in mental development (Stenson, Reuters Health, 2/19).