医学上，在怀孕期间HIV感染的女性患者在使用抗逆转录病毒药物，是防止艾滋病通过母婴传播非常有效的措施。感染HIV的女性患者在接受抗逆转录病毒药物治疗后，母婴途径传播艾滋病毒的风险从15~25%下降到1%以下。
唇腭裂是口腔颌面部最常见的先天性畸形，平均每生700个婴儿中就有1个患唇腭裂。唇腭裂不仅严重影响面部美观，还因口、鼻腔相通，直接影响发育，经常招致上呼吸道感染，并发中耳炎。
虽然抗逆转录病毒药物有防止艾滋病毒母婴传播的功效，但目前发表在Cleft Palate Craniofac J上一项研究表明：抗逆转录病毒与唇腭裂之间有密切相关性，抗逆转录病毒药物可能会导致婴儿出生缺陷如唇腭裂等。
该研究分析了FDA不良事件报告系统中近5年来药物引发先天性缺陷的相关数据。研究结果证实：虽然抗逆转录病毒药物能防止艾滋病通过母婴传播，但这些怀孕的准妈妈们的孩子在出生时经常会带有先天性疾病。
这项研究共发现在所有已上市的26个抗逆转录病毒药物中，有7个抗病毒药物会导致婴儿唇腭裂事件发生。
但研究人员强调要确定抗逆转录病毒药物与唇腭裂之间是否直接有关还要进一步开展研究。(生物谷 Bioon.com)
doi:10.1597/10-095
PMC:
PMID:
Antiretroviral Prophylaxis and the Risk of Cleft Lip and Palate: Preliminary Signal Detection in the Food and Drug Administration's Adverse Events Reporting System Database
Vassiliki M. Cartsos, D.M.D., M.S.D., Pinelopi Kleio Palaska, D.M.D., Athanasios I. Zavras, D.M.D., M.S., Dr.MSc.
Objective: Antiretroviral prophylaxis has been found to be effective in preventing vertical HIV transmission to the offspring of infected mothers. Because medicine and the art of public health require benefits to outweigh any plausible risks, our study aimed to explore and quantify preliminary associations between antiretroviral medications and clefting.
Methods: We analyzed 5 years of available data from the Food and Drug Administration's Adverse Events Reporting System (Medwatch program) and calculated reporting odds ratios (RORs) and their associated 95% confidence intervals (CIs).
Results: The medications with the highest effects were efavirenz with an ROR of 196 (95% CI, 86 to 447), lamivudine with an ROR of 60.2 (95% CI, 14.25 to 148), the combination abacavir sulfate/lamivudine/zidovudine with an ROR of 59.3, and nelfinavir with and ROR of 50.5, followed by nevirapine, lopinavir/ritonavir, and lamivudine/zidovudine.
Conclusion: Given the multifactorial etiology of cleft lip and palate, further studies are needed to assess the relative safety of antiretroviral prophylaxis and the specific conditions or potential synergies that might lead to the development of this defect.
