Document Detail


Infectious disease morbidity among young HIV-1-exposed but uninfected infants in Latin American and Caribbean countries: the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study.
MedLine Citation:
PMID:  17296782     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The goal was to describe the frequency, characteristics, and correlates of infectious disease morbidity during the first 6 months of life among HIV-1-exposed but uninfected infants. METHODS: The study population consisted of infants enrolled in the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study who were HIV-1 uninfected and had follow-up data through the 6-month study visit. Definitive and presumed infections were recorded at study visits (birth, 6-12 weeks, and 6 months). RESULTS: Of 462 HIV-1-uninfected infants with 11,644 child-weeks of observation, 283 experienced > or = 1 infection. These 283 infants experienced 522 infections (1.8 infections per infant). The overall incidence rate of infections was 4.5 cases per 100 child-weeks of observation. Overall, the most common infections were skin or mucous membrane infections (1.9 cases per 100 child-weeks) and respiratory tract infections (1.7 cases per 100 child-weeks). Thirty-six percent of infants had > 1 respiratory tract infection (1.8 cases per 100 child-weeks). Incidence rates of upper and lower respiratory tract infections were similar (0.89 cases per 100 child-weeks and 0.9 cases per 100 child-weeks, respectively). Cutaneous and/or oral candidiasis occurred in 48 neonates (10.3%) and 92 older infants (19.3%). Early neonatal sepsis was diagnosed in 12 infants (26.0 cases per 1000 infants). Overall, 81 of 462 (17.5%) infants were hospitalized with an infection. Infants with lower respiratory tract infections were hospitalized frequently (40.7%). The occurrence of > or = 1 neonatal infection was associated with more-advanced maternal HIV-1 disease, tobacco use during pregnancy, infant anemia, and crowding. Lower maternal CD4+ cell counts, receipt of intrapartum antibiotic treatment, and country of residence were associated with postneonatal infections. CONCLUSIONS: Close monitoring of HIV-1-exposed infants, especially those who are anemic at birth or whose mothers have more-advanced HIV-1 disease or who smoked during pregnancy, remains important.
Authors:
Marisa M Mussi-Pinhata; Laura Freimanis; Aparecida Y Yamamoto; James Korelitz; Jorge A Pinto; Maria L S Cruz; Marcelo H Losso; Jennifer S Read;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-02-12
Journal Detail:
Title:  Pediatrics     Volume:  119     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-02     Completed Date:  2007-03-27     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e694-704     Citation Subset:  AIM; IM    
Affiliation:
University of Sao Paulo, Ribeirão Preto, Sao Paulo, Brazil. mmmpinha@fmrp.usp.br
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MeSH Terms
Descriptor/Qualifier:
Anemia / epidemiology
Anti-Bacterial Agents / therapeutic use
Anti-Retroviral Agents / therapeutic use
Caribbean Region / epidemiology
Cohort Studies
Communicable Diseases / epidemiology*,  immunology
Comorbidity
Confidence Intervals
Female
Follow-Up Studies
HIV Infections / epidemiology,  immunology*
HIV Seronegativity*
HIV-1 / immunology*
Hospitalization / statistics & numerical data
Humans
Infant
Infant, Newborn
Latin America / epidemiology
Male
Multivariate Analysis
Odds Ratio
Pregnancy
Pregnancy Complications, Infectious / drug therapy,  epidemiology
Prenatal Exposure Delayed Effects / epidemiology*,  immunology
Prospective Studies
Socioeconomic Factors
Grant Support
ID/Acronym/Agency:
N01-HD-3-3345/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Retroviral Agents

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