Timing of HIV treatment during pregnancy could affect developmental delays in children

April 21, 2023 – During pregnancy, the timing of when mothers start taking antiretroviral (ARV) drugs to treat HIV may impact the risk of developmental delays in children, according to a study co-authored by researchers at the Center for Biostatistics in AIDS Research at Harvard T.H. Chan School of Public Health.

Researchers involved in the study, published March 10 in the journal AIDS Patient Care and STDs, included first author Tzy-Jyun Yao, senior research scientist in the Department of Biostatistics, and senior author Paige Williams, senior lecturer on biostatistics in the Department of Biostatistics and faculty affiliate in the Department of Epidemiology.

The study noted that, first and foremost, antiretroviral treatment during pregnancy greatly reduces the chance of mother-to-child transmission of HIV. But because the drugs are known to cross the placental barrier and fetal brains are affected by the womb environment, the researchers investigated the effects of drug exposure on developmental delays—specifically in language, behavior, and cognition—in five-year-old children.

The researchers found that the risk of developmental delays was not affected when mothers began antiretroviral treatment before pregnancy, meaning that children were exposed to the drugs beginning at the point of conception. However, the risk was higher when mothers started treatment during pregnancy, after conception. In particular, the drug atazanavir (ATV) was associated with increased risk.

The study results suggest that “ongoing surveillance of the safety and short- and long-term impact of ATV and other ARV medications upon developmental outcomes is warranted,” the authors wrote.

Read a Health Day article about the study: Kids whose moms took HIV meds while pregnant may be at higher risk for developmental delays

Read the study: In Utero Antiretroviral Exposure and Risk of Neurodevelopmental Problems in HIV-Exposed Uninfected 5-Year-Old Children