Document Detail


Survival of infants in the context of prevention of mother to child HIV transmission in South Africa.
MedLine Citation:
PMID:  20096027     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: We sought to study the survival of newborn children according to HIV status of the mother, that of the child and the timing of infection. METHODS: This is a prospective cohort study of 883 mothers (665 HIV-positive and 218 HIV-negative) and their infants. Data were collected using semi-structured questionnaires during home visits between the antenatal period and 36 weeks post-delivery. Infant HIV status was determined at 3, 24 and 36 weeks by HIV DNA PCR. RESULTS: The majority (81.3%) of infected infants who died were infected by 3 weeks of age. Of the HIV-exposed infants who died, 19 (28.4%) died before 6 weeks and 38 (56.7%) died by 12 weeks. The hazard ratio (HR) of mortality at 36 weeks of age in HIV-infected infants compared with exposed but negative infants was 8.9 (95% CI: 6.7-11.8). There was no significant difference in 36 week survival rates between HIV-non-exposed and HIV-exposed but negative infants (HR: 0.7; 95% CI: 0.3-1.5). The infant being HIV-positive at age 3 weeks (HR: 32 95% CI: 14.0-73.1) and rural site (HR: 4.4 95% CI: 1.2-23.4) were the two independent risk factors for infant death amongst HIV-exposed infants. CONCLUSION: The prognosis for infants with early HIV infection was very poor in this cohort. A greater focus on prevention of early infection, earlier screening for HIV infection and access to antiretrovirals for eligible infants is recommended.
Authors:
M Chopra; T Doherty; A Goga; D Jackson; L A Persson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2010-01-19
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  99     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  694-8     Citation Subset:  IM    
Affiliation:
Health Systems Research Unit, Medical Research Council, Tygerberg, Western Cape, South Africa. mchopra@unicef.org
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MeSH Terms
Descriptor/Qualifier:
DNA, Viral
Female
HIV Infections / mortality,  prevention & control,  transmission*
HIV-1*
Humans
Infant Mortality*
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control*
Kaplan-Meiers Estimate
Male
Polymerase Chain Reaction
Prognosis
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk Factors
South Africa / epidemiology
Chemical
Reg. No./Substance:
0/DNA, Viral

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


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