HIV Transmission to Extremely Low Birth Weight Infants

Tooke, Lloyd; Horn, A; Harrison, Michael

doi:10.1097/inf.0b013e318270097e

Cited by 9 publications

(8 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 51 HIV-exposed infants, mean birth weight was 834 g and mean gestational age was 28.3 weeks. Most were born by caesarean section before active labour, with a transmission rate of 2.7% by six weeks of age [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

Cotton

Holgate

Nelson

et al. 2015

Journal of the International AIDS Society

View full text Add to dashboard Cite

IntroductionThere is new emphasis on identifying and treating HIV in the first days of life and also an appreciation that low birth weight (LBW) and preterm delivery (PTD) frequently accompany HIV-related pregnancy. Even in the absence of HIV, PTD and LBW contribute substantially to neonatal and infant mortality. HIV-exposed and -infected infants with these characteristics have received little attention thus far. As HIV programs expand to meet the 90-90-90 target for ending the HIV pandemic, attention should focus on newborn infants, including those delivered preterm or of LBW.DiscussionIn high prevalence settings, infant diagnosis of HIV is usually undertaken after the neonatal period. However, as in utero infection may be diagnosed at birth, earlier initiation of therapy may limit viral replication and prevent early damage. Globally, there is growing awareness that preterm and LBW infants constitute a substantial proportion of births each year. Preterm infants are at high risk for vertical transmission. Feeding difficulties, apnoea of prematurity and vulnerability to sepsis occur commonly. Feeding intolerance, a frequent occurrence, may compromise oral administration of medications. Although there is growing experience with post-exposure prophylaxis for HIV-exposed term newborn infants, there is less experience with preterm and LBW infants. For treatment, there are even fewer options for preterm infants. Only zidovudine has adequate dosing recommendations for treating term and preterm infants and has an intravenous formulation, essential if feeding intolerance occurs. Nevirapine dosing for prevention, but not treatment, is well established for both term and preterm infants.HIV diagnosis at birth is likely to be extremely stressful for new parents, more so if caring for preterm or LBW infants. Programs need to adapt to support the medical and emotional needs of young infants and their parents, where interventions may be lifesaving.ConclusionsNew focus is required for the newborn baby, including those born preterm, with LBW or small for gestational age to consolidate gains already made in early diagnosis and treatment of young children.

show abstract

Section: Discussionmentioning

confidence: 99%

The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

Cotton

Holgate

Nelson

et al. 2015

Journal of the International AIDS Society

View full text Add to dashboard Cite

show abstract

“…This neonatal unit has ~2 000 admissions per annum and acts as the tertiary referral centre for the Metro West area of Cape Town, with a total of ~40 000 deliveries per annum. [11] The GSH treatment protocol for syphilis-exposed neonates is dependent on maternal treatment status and neonatal symptoms. A mother is considered fully treated once she has received three weekly intramuscular doses of benzathine penicillin, with the third dose >1 month before delivery.…”

Section: Methods Settingmentioning

confidence: 99%

Symptomatic congenital syphilis in a tertiary neonatal unit in Cape Town, South Africa: High morbidity and mortality in a preventable disease

Pillay

Tooke

2019

S Afr Med J

View full text Add to dashboard Cite

“…positive are initiated on lifelong ART, the HIV transmission rate in VLBW infants in our population is comparable to the national HIV transmission rate in all infants, irrespective of weight. Transmission rates between 1.6% and 7.7% have been reported; Tooke et al, [8] in 2013, did a cross-sectional retrospective review of extremely low-birthweight infants (<1 000 g) to determine the HIV transmission rate at six weeks of age. They reported a 2.7% risk of transmission.…”

Section: Researchmentioning

confidence: 99%

HIV prevalence at birth in very low-birthweight infants

John

Harper

2020

S Afr J CH

View full text Add to dashboard Cite

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. The human immunodeficiency virus (HIV) is an ongoing threat to the health and wellbeing of children worldwide. In 2013, 1.3 million women living with HIV gave birth. [1] A closer look at these figures shows that 85% of all pregnant women, worldwide, living with HIV, reside in sub-Saharan Africa. [1] Since implementation of the highly effective prevention of mother-to-child transmission (PMTCT) programme in 2004, the incidence of vertically infected infants has declined. Despite this progress, an estimated 12 000 children were newly infected with HIV owing to mother-tochild transmission in South Africa (SA) in 2016 alone. [2] By promoting early diagnosis and, when necessary, timeous initiation of antiretroviral therapy (ART), one can reduce mortality, disease progression and neurodevelopmental impairment in children infected by HIV. [3] Mother-to-child transmission of HIV can occur in utero, intrapartum and via breastfeeding. In April 2015, the SA PMTCT guidelines recommended that all infants should be tested for HIV infection at birth. [4] In 2016, the overall (all weight categories) transmission rate at birth was 1.1%. [5] In utero HIV transmission rates in very low-birthweight (VLBW) infants is largely unknown, and more so in the Eastern Cape. In 2017, 31% of all VLBW infants born at East London public sector hospitals were HIV exposed. [6] Knowledge concerning this group of infants is important, as VLBW infants are at increased risk of in utero HIV transmission. [7-10] We aimed to report the prevalence of HIV infection in infants weighing less than 1 500 g (VLBW infants) at birth and to describe the characteristics of those infants who had a positive HIV polymerase chain reaction (PCR) test. Methods This was a retrospective cross-sectional study performed at Frere Hospital, East London, and Cecilia Makiwane Hospital, Mdantsane, SA, during a two-year study period between 1 May 2016 and 31 April 2018. Both hospitals follow current national paediatric guidelines in testing all HIV-exposed infants for HIV infection at birth. The qualitative HIV PCR assay used for infant HIV testing was the Roche Cobas Ampliprep/Cobas TaqMan (CAP/CTM). VLBW infants, i.e. weighing <1 500 g at birth, born to women living with HIV, were included in the study. Infants <500 g were excluded from the study as they are not admitted to the nursery owing to poor viability. Information was extracted from neonatal and hospital records and entered into an Excel (Microsoft Corp., USA) database. Data captured included maternal information (age, current ART details such as regimen, number of months on ART in relation to delivery and HIV viral load) and infant details (birthweight, HIV PCR result and Ballard gestational score). Ethics approval was granted by the Walter Sisulu University (WSU) Human Research Ethics Committee (ref. no. 039/2018). The clinical governance of the two hospitals gave permission for implementation of the study protocol. As this was a retro...

show abstract

HIV Transmission to Extremely Low Birth Weight Infants

Cited by 9 publications

References 48 publications

The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

Symptomatic congenital syphilis in a tertiary neonatal unit in Cape Town, South Africa: High morbidity and mortality in a preventable disease

HIV prevalence at birth in very low-birthweight infants

Contact Info

Product

Resources

About