HIV-exposed uninfected infant morbidity and mortality within a nationally representative prospective cohort of mother-infant pairs in Zimbabwe

Patel Monita R.; Mushavi Angela; Balachandra Shirish; Shambira Gerald; Nyakura Justice; Mugurungi Owen; Kilmarx Peter H.; Rivadeneira Emilia; Dinh Thu-Ha

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HIV-exposed uninfected infant morbidity and mortality within a nationally representative prospective cohort of mother-infant pairs in Zimbabwe

机译：在津巴布韦的国家代表前瞻性母婴对中的艾滋病毒暴露未感染的婴儿发病率和死亡率

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Objective: To examine morbidity and mortality risk among HIV-exposed uninfected (HEU) infants. Design: Secondary data analysis of HEU infants in a prospective cohort study of mother-infant pairs. Methods: Infants were recruited from immunization clinics (n = 151) in Zimbabwe from February to August 2013, enrolled at 4-12 weeks age, and followed every 3 months until incident HIV-infection, death, or 18-month follow-up. We estimated cumulative mortality probability and hazard ratios with 95% confidence intervals (CIs) using Kaplan-Meier curves and Cox regression, respectively. We also described reported reasons for infant hospitalization and symptoms preceding death. Median weight-for-agez-scores (WAZ) and median age were calculated and analyzed across study visits. Results: Of 1188 HIV-exposed infants, 73 (6.1%) contracted HIV; we analyzed the remaining 1115 HEU infants. In total, 54 (4.8%) infants died, with median time to death of 5.5 months since birth (interquartile range: 3.6-9.8 months). Diarrhea, difficulty breathing, not eating, fever, and cough were commonly reported (range: 7.4-22.2%) as symptoms preceding infant death. Low birth weight was associated with higher mortality (adjusted hazard ratio 2.66, CI: 1.35-5.25), whereas maternal antiretroviral therapy predelivery (adjusted hazard ratio 0.34, CI: 0.18-0.64) and exclusive breastfeeding (adjusted hazard ratio 0.50, CI: 0.28-0.91) were associated with lower mortality. Overall, 9.6% of infants were hospitalized. Infant median WAZ declined after 3 months of age, reaching a minimum at 14.5 months of age, at which 50% of infants were underweight (WAZ below -2.0). Conclusion: Clinical interventions including maternal antiretroviral therapy; breastfeeding and infant feeding counseling and support; and early prevention, identification, and management of childhood illness; are needed to reduce HEU infant morbidity and mortality.

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来源
《AIDS》 |2020年第9期|共8页
作者
Patel Monita R.; Mushavi Angela; Balachandra Shirish; Shambira Gerald; Nyakura Justice; Mugurungi Owen; Kilmarx Peter H.; Rivadeneira Emilia; Dinh Thu-Ha;
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作者单位

US Ctr Dis Control &

Prevent Div Global HIV &

TB Ctr Global Hlth 1600 Clifton Rd NE MS-E04;

Minist Hlth &

Child Care Zimbabwe AIDS &

TB Dept Harare Zimbabwe;

US Ctr Dis Control &

Prevent Div Global HIV &

TB Ctr Global Hlth Harare Zimbabwe;

Univ Zimbabwe Dept Community Hlth Harare Zimbabwe;

Univ Zimbabwe Dept Community Hlth Harare Zimbabwe;

Minist Hlth &

Child Care Zimbabwe AIDS &

TB Dept Harare Zimbabwe;

US Ctr Dis Control &

Prevent Div Global HIV &

TB Ctr Global Hlth 1600 Clifton Rd NE MS-E04;

US Ctr Dis Control &

Prevent Div Global HIV &

TB Ctr Global Hlth 1600 Clifton Rd NE MS-E04;

US Ctr Dis Control &

Prevent Div Global HIV &

TB Ctr Global Hlth 1600 Clifton Rd NE MS-E04;

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原文格式 PDF
正文语种 eng
中图分类传染病;
关键词
HIV-exposed-uninfected infants; morbidity; mortality; Zimbabwe;

机译：艾滋病毒暴露 - 未感染的婴儿;发病率;死亡率;津巴布韦;

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机译：抗逆转录病毒治疗及出生体重对母婴患者的影响的影响：从选项A到津巴布韦的选项B +期间的一个18个月的母婴对的一个18个月前瞻性队列的全国代表性样本的调查结果
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8. Vitamin D Status Is Associated with Mortality, Morbidity, and Growth Failure among a Prospective Cohort of HIV-Infected and HIV-Exposed Tanzanian Infants [J] . Christopher R Sudfeld4*, Christopher Duggan57, Said Aboud8, The Journal of Nutrition: Official Organ of the American Institute of Nutrition . 2015,第1期

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12. Effect of colostrum given within the 12 hours after birth on feeding outcome, morbidity and mortality in very low birth weight infants: a prospective cohort study [O] . Tanveer Bashir, Kallem Reddy, Sai Kiran, 2019

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13. Guidelines for the Prevention and Treatment of Opportunistic Infections among HIV-Exposed and HIV-Infected Children. Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Disease Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. Morbidity and Mortality Weekly Report, Recommendations and Reports, Volume 58, RR-11 [R] . 2009

机译：预防和治疗艾滋病毒暴露和艾滋病毒感染儿童的机会性感染指南。疾病预防控制中心，美国国立卫生研究院，美国传染病学会艾滋病医学协会，儿科传染病学会和美国儿科学会的建议。发病率和死亡率每周报告，建议和报告，第58卷，RR-11

HIV-exposed uninfected infant morbidity and mortality within a nationally representative prospective cohort of mother-infant pairs in Zimbabwe

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