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The Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes among Human Immunodeficiency Virus-Exposed, Uninfected Infants.
MedLine Citation:
PMID:  22581219     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The World Health Organization guidelines recommend cotrimoxazole prophylactic treatment (CPT) for all HIV-exposed infants from age 6 weeks to the cessation of breastfeeding and the exclusion of HIV infection. There are limited data about the effects of CPT among this population of infants. We examined the effects of CPT on adverse health outcomes among HIV-exposed infants during the first 36 weeks of life by using data from the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, a large clinical trial of antiretroviral drugs given to the mother or infant for prevention of HIV transmission during breastfeeding. METHODS:: For the analysis, we assigned a status of CPT-exposed to infants who were participating in the study after the CPT program started. We estimated unadjusted and adjusted hazard ratios (HRs) for the effect of CPT status on time to incident malaria, severe illness or death, anemia, and weight-for-age Z score < -2.0. Participation in the study was limited to focus exclusively on HIV-exposed, uninfected infants. RESULTS:: The HR for the effect of CPT on incident malaria was 0.35 (95% confidence interval [CI]: 0.21, 0.57) during the first 10 weeks of CPT exposure, and 0.93 (95% CI: 0.67, 1.29) for the remaining 20 weeks. CPT was not associated with the other outcomes examined. CONCLUSIONS:: CPT offered temporary protection against malaria among HIV-exposed, uninfected infants. However, CPT offered no protection against anemia, low weight for age, or the collapsed outcome of severe illness or death.
Authors:
Anna Dow; Dumbani Kayira; Michael Hudgens; Annelies Van Rie; Caroline C King; Sascha Ellington; Athena Kourtis; Abigail Norris Turner; Steven Meshnick; Zebrone Kacheche; Denise J Jamieson; Charles Chasela; Charles van der Horst
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-10
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA bUniversity of North Carolina Project, Lilongwe, Malawi cDepartment of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA dCenters for Disease Control and Prevention, Atlanta, GA, USA eOhio State University, Columbus, OH, USA fUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
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