Abuse of antiretroviral drugs combined with addictive drugs by pregnant women is associated with adverse effects in infants and risk of resistance

Abstract

Reports of the use of antiretroviral drugs (ARVs) to produce a highly addictive drug called nyaope or whoonga are of major concern as ARVs are easily  accessible in sub-Saharan Africa, including to pregnant women. Use of illicit drugs by pregnant women may result in serious adverse effects in their  infants. We have noticed a sudden increase in the number of infants  presenting with signs suggestive of neonatal abstinence in Chris Hani   Baragwanath Academic Hospital. Here we report two neonates who were born to mothers addicted to nyaope. Both infants were growth restricted and  presented with signs of neonatal abstinence syndrome that are likely due to nyaope or whoonga. We suggest that in growth-restricted infants born to mothers who are at high risk of substance abuse and/or are receiving ARVs,
screening for substance abuse should be considered.