Document Detail


Morbidity among human immunodeficiency virus-exposed but uninfected, human immunodeficiency virus-infected, and human immunodeficiency virus-unexposed infants in Zimbabwe before availability of highly active antiretroviral therapy.
MedLine Citation:
PMID:  21173675     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Human immunodeficiency virus (HIV) remains a major cause of pediatric morbidity in Africa. In addition, HIV-exposed, but uninfected (HEU) infants can comprise a substantial proportion of all infants born in high prevalence countries and may also be a vulnerable group with special health problems.
METHODS: A total of 14,110 infants were recruited within 96 hours of birth between November 1996 and January 2000. Rates and causes of sick clinic visits and hospitalizations during infancy were investigated according to infant HIV infection group: infected-intrauterine, infected-intrapartum, postnatally-infected, HEU, and not-exposed (born to HIV-negative mother).
RESULTS: A total of 382 infected-intrauterine, 499 infected-intrapartum, 188 postnatally-infected, 2849 HEU, and 9207 not-exposed infants were included in the analysis. Compared with not-exposed infants, HIV-infected infants made 2.8 times more all-cause sick clinic visits and required 13.3 times more hospitalizations; they had 7.2 times more clinic visits and 23.5 times more hospitalizations for lower respiratory tract infection after the neonatal period and were 159.9 times more likely to be hospitalized for malnutrition during the second half of infancy. Compared with not-exposed infants, sick clinic visits were 1.2 times more common among HEU infants, were inversely associated with maternal CD4 cell count, and were significantly higher for all HEU infants except those whose mothers had a CD4 count ≥ 800 cells/μL, which was the mean value of HIV-negative women enrolled in the trial.
CONCLUSIONS: Morbidity is extremely high among HIV-infected infants. Compared with not-exposed infants, morbidity is higher among HEU infants and increases with severity of maternal disease, but is significantly higher for all mothers with CD4 cell count <800 cells/μL.
Authors:
Ai Koyanagi; Jean H Humphrey; Robert Ntozini; Kusum Nathoo; Lawrence H Moulton; Peter Iliff; Kuda Mutasa; Andrea Ruff; Brian Ward;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  30     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  2011-07-14     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-51     Citation Subset:  IM    
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care / statistics & numerical data
Antiretroviral Therapy, Highly Active
Chi-Square Distribution
Cohort Studies
Female
HIV Infections / epidemiology*
HIV-1
Hospitalization / statistics & numerical data
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical / statistics & numerical data*
Male
Morbidity
Pregnancy
Statistics, Nonparametric
Zimbabwe / epidemiology
Investigator
Investigator/Affiliation:
Henry Chidawanyika / ; John Hargrove / ; Agnes I Mahomva / ; Florence Majo / ; Lucie C Malaba / ; Michael T Mbizvo / ; Faith Mzengeza / ; Mary Ndhlovu / ; Ellen Piwoz / ; Lidia Propper / ; Phillipa Rambanepasi / ; Andrea J Ruff / ; Naume Tavengwa / ; Lynn S Zijenah / ; Clare D Zunguza / ; Partson Zvandasara /

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


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