Background Since 1996, HAART progressively replaced ZDV monotherapy to prevent mother-to- child HIV transmission  Is HAART associated with low birthweight independently on gestational age? Methods Study population All uninfected neonates born to HIV-infected mothers enrolled in the ANRS French Perinatal Cohort (EPF) : – n=6538 Excepted: untreated mothers, late booking (> 28 wks gestation), drug users, twin pregnancies Anthropometric parameters Birthweight Z-scores, adjusted for gestational age at delivery and sex (French standards : Audipog) Lack of association between birthweight and prepartum HAART administered to mothers of HIV-uninfected neonates N. Briand, J. Le Chenadec, S. Blanche, J.-P. Teglas, C. Dollfus, A. Faye, C. Rouzioux, R. Tubiana, J. Warszawski, L. Mandelbrot, ANRS French Perinatal Cohort

Evolution of birthweight for each gestational age at birth <32 Gestational weeks Treatment evolution Monotherapy 99% 18%19%2% Bitherapy1% 65% 21%5% Multitherapy17% 60%93% 2006

Association between multitherapy and birthweight linear regression Median Z-scores Multivariate analysis ARV Mean diff. (95% CI)P : Monotherapy-0.19Ref : Bitherapy (-0.14;0.17) : Mono exclusively (0.02;0.29) Bitherapy (-0.03;0.23) Haart/Mono/Dual (-0.03;0.31) Haart exclusively (-0.11;0.12) : Haart exclusively (-0.21;0.05) Global test (p) Adjustment for time at first antenatal visit, sub-Saharan African origin, maternal age, parity and CD4 cell count When taking into account gestational age at birth, neonates exposed to exclusive HAART in did not have lower birthweight, compared to neonates exposed to monotherapy in the reference period