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However, in utero exposure to antiretrovirals (ARVs) leads to abnormalities in HIV\u2010exposed uninfected (HEU) infants. We determined the effect of five ARVs on human umbilical cord blood (UCB)\u2010derived haematopoietic stem\/progenitor cells (HSPC) with the aim of exploring a potential causal relationship with haematological abnormalities. Efavirenz (EFV) was cytotoxic to HSPCs alone and in combination with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). Dolutegravir (DTG) had a biphasic effect on HSPC expansion. Immunophenotypic analysis showed increased erythroid and granulocyte precursors after 7\u2010day culture with these drugs. Finally, using colony forming unit (CFU) assays, we observed impairment in the formation of CFU\u2010GEMM and CFU\/Burst forming unit (BFU) erythroid (E) in the presence of DTG, lamivudine (3TC) and TDF, both visually and immunophenotypically. We conclude that multiple potential HSPC toxicities exist with ARVs commonly used in pregnancy, prompting the need for further research to confirm the safety of these drugs in this vulnerable group.<\/jats:p>","DOI":"10.1111\/jcmm.70557","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T06:10:01Z","timestamp":1745820601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiretroviral\u2010Induced Toxicity in Umbilical Cord Blood\u2010Derived Haematopoietic Stem\/Progenitor Cells"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-6605","authenticated-orcid":false,"given":"Candice Laverne","family":"Hendricks","sequence":"first","affiliation":[{"name":"Department of Immunology, Faculty of Health Sciences, Institute for Cellular and Molecular Medicine University of Pretoria  Pretoria South Africa"},{"name":"SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ellero","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juanita","family":"Mellet","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Health Sciences, Institute for Cellular and Molecular Medicine University of Pretoria  Pretoria South Africa"},{"name":"SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Voula","family":"Stivaktas","sequence":"additional","affiliation":[{"name":"Beckman Coulter Life Sciences  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Sean","family":"Pepper","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Health Sciences, Institute for Cellular and Molecular Medicine University of Pretoria  Pretoria South Africa"},{"name":"SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS \u201cWord AIDS Day 2023: Global HIV Statistics \u201d(2023) [cited 2023 Dec 18] https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12403"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198707233170401"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v18i1.776"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507198"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-018-0201-6"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP1918"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01523-08"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-014-0185-7"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3283"},{"key":"e_1_2_10_13_1","unstructured":"Republic of South Africa National Department of Health \u201c2023 ART Clinical Guidelines for the Management of HIV in Adults Pregnancy and Breastfeeding Adolescents Children Infants and Neonates \u201d(2023)."},{"key":"e_1_2_10_14_1","unstructured":"World Health Organisation \u201cPolicy Brief: Update of Recommendations on First\u2010and Second\u2010Line Antiretroviral Regimens. 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