Impact of HIV Exposure on Health Outcomes in HIV-Negative Infants Born to HIV-Positive Mothers in Sub-Saharan Africa
| Autor: | Eusebio Macete, Clara Menéndez, Nilsa de Deus, Cinta Moraleda, Denise Naniche, Llorenç Quintó, Celia Serna-Bolea, Montse Renom |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Anemia Population CD4-CD8 Ratio Mothers HIV Infections Hematocrit Polymerase Chain Reaction Young Adult Child Development Surveys and Questionnaires medicine Humans Pharmacology (medical) Prospective Studies Prospective cohort study education Africa South of the Sahara Mozambique education.field_of_study medicine.diagnostic_test business.industry Transmission (medicine) Incidence (epidemiology) Malnutrition Infant Newborn Infant medicine.disease Confidence interval CD4 Lymphocyte Count Diarrhea Infectious Diseases DNA Viral Female medicine.symptom business |
| Zdroj: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 65:182-189 |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/qai.0000000000000019 |
| Popis: | BACKGROUND: Up to 30% of infants may be HIV-exposed noninfected (ENI) in countries with high HIV prevalence but the impact of maternal HIV on the childs health remains unclear. METHODS: One hundred fifty-eight HIV ENI and 160 unexposed (UE) Mozambican infants were evaluated at 1 3 9 and 12 months postdelivery. At each visit a questionnaire was administered and HIV DNA polymerase chain reaction and hematologic and CD4/CD8 determinations were measured. Linear mixed models were used to evaluate differences in hematologic parameters and T-cell counts between the study groups. All outpatient visits and admissions were registered. ENI infants received cotrimoxazol prophylaxis (CTXP). Negative binomial regression models were estimated to compare incidence rates of outpatient visits and admissions. RESULTS: Hematocrit was lower in ENI than in UE infants at 1 3 and 9 months of age (P = 0.024 0.025 and 0.012 respectively). Percentage of CD4 T cells was 3% lower (95% confidence interval: 0.86 to 5.15; P = 0.006) and percentage of CD8 T cells 1.15 times higher (95% confidence interval: 1.06 to 1.25; P = 0.001) in ENI vs. UE infants. ENI infants had a lower weight-for-age Z score (P = 0.049) but reduced incidence of outpatient visits overall (P = 0.042) diarrhea (P = 0.001) and respiratory conditions (P = 0.042). CONCLUSIONS: ENI children were more frequently anemic had poorer nutritional status and alterations in some immunologic profiles compared with UE children. CTXP may explain their reduced mild morbidity. These findings may reinforce continuation of CTXP and the need to understand the consequences of maternal HIV exposure in this vulnerable group of children. |
| Databáze: | OpenAIRE |
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