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To the Editor: In their Research Letter, Dr De Santis and colleagues¹ reported a possible association of infantile hemangiomas with combined antiretroviral therapy (CART) during pregnancy. As a control group, the authors identified all pregnancies in which the mother had contacted a teratology information service. There are numerous ways, however, in which these groups are not comparable, and which may thus confound the observed association. First, the control group was self-selected. Second, infantile hemangiomas are very common. Although their precise incidence is not known, estimates range from 4% to 10%.² In addition, the increased frequency found in female and premature infants³ could easily have confounded the increase in the group treated with CART.

No data were given to judge the basic comparability of the CART and control groups. In the report of Lorenzi et al⁴ cited by the authors, 2 of 30 (6.7%) infants had "angiomas" in a cohort in . . . [Full Text of this Article]

Ilona J. Frieden, MD; Anita N. Haggstrom, MD; Charles McCulloch, PhD
University of California, San Francisco

Beth Drolet, MD; Nancy B. Esterly, MD
Medical College of Wisconsin
Milwaukee

Maria C. Garzon, MD
Columbia University
New York, NY

Anne W. Lucky, MD
Cinncinati Childrens Hospital
Cinncinati, Ohio

Eulalia Baselga, MD
Hospital de la Santa Creu i Sant Pau
Barcelona, Spain

Sheila F. Friedlander, MD
Childrens Hospital San Diego
San Diego, Calif

RELATED LETTER

Hemangiomas and Other Congenital Malformations in Infants Exposed to Antiretroviral Therapy In Utero
Marco De Santis, Anna Franca Cavaliere, Alessandro Caruso, Paola Villa, Enrica Tamburrini, Roberto Cauda, Carlo Fundaro, and Orazio Genovese
JAMA. 2004;291(3):305.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Combined Antiretroviral Therapy During Pregnancy and Risk of Congenital Malformations—Reply
Marco De Santis, Anna Franca Cavaliere, Alessandro Caruso, Paola Villa, Enrica Tamburrini, Roberto Cauda, Carlo Fundaro, and Orazio Genovese
JAMA. 2004;291(16):1962.
EXTRACT | FULL TEXT