Bone Health in Infants: Insights on HIV Medication Exposure and Effects

Bone Health in Infants: Insights on HIV Medication Exposure and Effects

November 16, 2024 Catherine Williams - Chief Editor Health

A study published in the Journal of the International AIDS Society on November 11 shows that bone health in infants born to women treated with tenofovir disoproxil fumarate (TDF) to prevent HIV infection is normal. This study took place in South Africa and involved 481 infants who underwent dual energy x-ray absorptiometry (DEXA) scans at various points: six, 26, 50, and 74 weeks of age.

Dhayendre Moodley, PhD, and colleagues conducted this research. They concluded that in-utero exposure to TDF does not affect bone integrity in breastfed infants during the first 18 months. TDF, in combination with emtricitabine (FTC), is commonly used as pre-exposure prophylaxis (PrEP) for pregnant women at high risk of HIV.

Though adult studies have linked TDF to lower bone mineral density, the researchers noted that data on infants born to mothers on TDF-PrEP was limited. Their findings indicated that infants whose mothers started TDF-FTC PrEP in the second trimester did not show significant differences in bone mineral content compared to those whose mothers did not use PrEP.

The study reported mean differences in bone mineral content (BMC) for the whole body with head and lumbar spine at the various age checkpoints, with no significant changes. For example, there were mean differences in BMC of -0.74 at six weeks and -1.26 at 26 weeks, but these results were not statistically significant (p = 0.283). The study authors stated, “There were no differences in bone mineral content of the whole body with head and lumbar spine.”

Furthermore, these results remained consistent even among women who adhered well to the PrEP regimen during pregnancy. Only one similar study exists, which found no difference in mean whole-body bone mineral density at 36 months among children with and without in-utero PrEP exposure.

The research reassures that in-utero exposure to TDF-PrEP does not negatively impact bone health in infants. To read the full study, you can find it here.