Document Detail


Effects of cotrimoxazole prophylactic treatment on adverse health outcomes among HIV-exposed, uninfected infants.
MedLine Citation:
PMID:  22801093     Owner:  NLM     Status:  MEDLINE    
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 on 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 using data from the Breastfeeding, Antiretrovirals and Nutrition study, a large clinical trial of antiretroviral drugs given to the mother or infant for the 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 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 hazard ratio for the effect of CPT on incident malaria was 0.35 (95% confidence interval: 0.21, 0.57) during the first 10 weeks of CPT exposure and 0.93 (95% confidence interval: 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; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  31     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-17     Completed Date:  2013-01-21     Revised Date:  2014-02-17    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  842-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anemia / epidemiology,  prevention & control
Anti-Retroviral Agents / therapeutic use*
Antibiotic Prophylaxis
Antimalarials / therapeutic use*
Body Weight
Breast Feeding
Chi-Square Distribution
Female
HIV Infections / drug therapy,  parasitology,  prevention & control*
Humans
Infant
Infant, Newborn
Kaplan-Meier Estimate
Malaria / prevention & control*,  virology
Mothers
Statistics, Nonparametric
Trimethoprim-Sulfamethoxazole Combination / therapeutic use*
Grant Support
ID/Acronym/Agency:
2-D43 TW01039-06/TW/FIC NIH HHS; P30 AI050410/AI/NIAID NIH HHS; P30-AI50410/AI/NIAID NIH HHS; U48-CCU409660-09//PHS HHS; U48-DP000059-0/DP/NCCDPHP CDC HHS; U48-DP001944-01/DP/NCCDPHP CDC HHS
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Antimalarials; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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