Congenital pyelectasis in children born from mothers on tenofovir containing therapy during pregnancy: report of two cases.

Given the success of highly active antiretroviral therapy in slowing HIV disease progression, an increasing proportion of HIV-infected women are choosing to become pregnant. Antiretroviral treatment decisions in these women must consider not only the immunological and virological efficacy of different drugs, but also their possible effects on the unborn baby. At present, data concerning the teratogenicity of more recent drugs are lacking. Tenofovir disoproxil fumarate, a nucleotide reverse transcriptase inhibitor, is widely used in patients pre-exposed to other nucleoside analogues because of its efficacy and tolerability. The routine use of prenatal ultrasonography has improved early identification of birth defects. Fetal urinary tract bnormalities are among the most commonly diagnosed prenatal malformations, with a reported prevalence as high as 1 per 100 pregnancies. Pyelectasis is defined as a renal pelvic dilatation, and is one of the most commonly founded urologic anomalies. The aim of this present communication is to describe a possible association between in utero tenofovir exposure and this renal congenital malformation.