Child Mortality According to Maternal and Infant HIV Status in Zimbabwe

Abstract

Perinatally infected infants are at particular risk of death between 2 and 6 months: cotrimoxazole prophylaxis and early pediatric HAART should be scaled up. Uninfected infants of infected mothers have at least twice the mortality risk of infants born to uninfected mothers: all HIV-exposed infants should be targeted with child survival interventions. HIV-positive mothers with more advanced disease are not only more likely to infect their infants, but their infants are more likely to die, whether infected or not: provision of antiretroviral treatment to pregnant and lactating women is an urgent need for both mothers and their children.

Inflammation and Immune Activation in Antiretroviral-Treated Human Immunodeficiency Virus Type 1–Infected African Infants and Rotavirus Vaccine Responses

“…Our study was, however, limited by lack of HIV-1-unexposed, uninfected infants as controls. Immunologic abnormalities and increased rates of severe infections in HEU compared with HIV-unexposed infants have been described [13][14][15]. Furthermore, longitudinal assessment of the concentrations of plasma cytokines throughout the vaccination period to further assess changes in cytokines on ART and with sequential exposure to oral viral vaccine antigens was not performed due to sample availability.…”

“…Cytokines commonly used to assess the inflammatory state in adult HIV-1 infection [7] 13], and tumor necrosis factor α [TNFα]) were quantified at study entry (prevaccination) and 21 days after the first vaccine dose using the ultrasensitive 10-plex human cytokine kit (V-Plex Proinflammatory Kit) from Meso-Scale Discoveries (Rockville, MD). Testing at additional time points was not performed due to lack of sample availability for the entire cohort.…”

Global Progress in PMTCT and Paediatric HIV Care and Treatment in Low-and Middle-Income Countries in 2004–2005

“…Cotrimoxazole, a highly effective antibiotic for preventing pneumonia and other opportunistic infections, and early paediatric antiretroviral treatment are fundamental for prolonging the lives of many infected infants. [20][21][22] Provision of cotrimoxazole prophylaxis for infants born to HIV positive mothers and HIV positive children has been slow in many countries. Cotrimoxazole can reduce child mortality in HIV positive children by over 40%, and has been part of the standard of care for preventing pneumonia and other opportunistic infections since the early 1990s.…”

Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study

“…The severity of immunosuppression, and high viral loads in infants (23)(24)(25) are associated with rapid progression of HIV infection. On the contrary, maternal treatment even with prophylactic regimen, would indirectly reduce the progression of the disease in the infant (15,16,19,26). Some associated factors could be found in our milieu because of concurrent illness.…”

“…Rapid progressors are infants who develop severe signs of AIDS very early in life usually leading to death for most of them (13,14). Many factors are described in literature concerning HIV-infected rapid progressors (15)(16)(17)(18). It has been proven that there is a relationship between high maternal viral load and severe immunodeficiency, and high viral load in infants (15,(19)(20)(21)(22).…”