By Jacqueline Stenson

Reuters 19 Feb. 2002

New York -- Giving HIV medication to women during pregnancy and delivery can dramatically reduce the odds that a woman will pass on her infection to the newborn. But French doctors report that the life-saving therapy may also have an unexpected side effect: increasing the risk of febrile seizures in early childhood.

Generally limited to kids under age 5, febrile seizures are convulsions that are associated with a high fever but not with epilepsy. Though febrile seizures are usually not serious and may only occur once, the new findings should prompt doctors to closely monitor children exposed to HIV therapy to make sure their mental development is normal, the researchers said.

Most importantly, however, HIV-infected pregnant women should not be discouraged from using drug therapy to try to prevent the spread of the virus to their babies, said study author Dr. Stephane Blanche. "Preventive treatment during pregnancy is one of the most beautiful success stories of [HIV] therapy," Blanche told Reuters Health in an e-mail interview. "There is no question about that."

The researchers looked at data on 4,426 babies from the French Perinatal Cohort study, an ongoing survey of HIV-infected women and their children. The majority of kids in the current analysis were HIV-negative, though in some cases their HIV status was unknown. The children were followed until 18 months of age.

Overall, there were relatively few febrile seizures--34 occurred in 30 children, the investigators reported in the February 16th issue of The Lancet. But the kids exposed to AZT or other HIV medications while in the womb, after delivery or both were more than twice as likely as other children to experience a febrile seizure, results showed.

Other types of seizures were not linked to the medications.

"In the vast majority of cases, febrile seizures in the general population are well-tolerated," Blanche said, but parents should be made aware of the potential risk. Blanche added that the investigators are now further analyzing the study group to see if treated children showed any problems in mental development, and if so, why.

Source: The Lancet 2002;359:583-584.