Infectious Disease Morbidity Among Young HIV-1–Exposed But Uninfected Infants in Latin American and Caribbean Countries: The National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study

Mussi-Pinhata, Marisa Márcia; Freimanis, Laura; Yamamoto, Aparecida Yulie; Korelitz, James; Pinto, Jorge; Cruz, Maria Letícia Santos; Losso, Marcelo; Read, Jennifer S.

doi:10.1542/peds.2006-1856

Cited by 85 publications

(71 citation statements)

References 32 publications

(31 reference statements)

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“…Among the neonatal characteristics associated with HIV-1 vertical transmission (Table 2), the present study analysis of the data demonstrates the protective effect of starting AZT prophylaxis immediately after birth, as recommended by the PN-DST/AIDS program in reducing MTCT. Several studies have indicated that even incomplete AZT regimens were effective in protecting newborns from HIV infection (JOÃO et al, 2003;MUSSI-PINHATA et al, 2007). In addition, the association between low birth weight and the HIV transmission observed has also been reported by others, linked mainly to poor nutritional status, anemia or low maternal body mass index.…”

Section: Discussionmentioning

confidence: 73%

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HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

Prestes-Carneiro

Spir

Ribeiro

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIn children, vertical transmission is the main form of HIV infection. Our aim was to determine the prevalence of HIV-1 vertical transmission in mother-infant pairs in a public maternity ward in Presidente Prudente, SP. Additionally; we sought to identify characteristics associated with this form of transmission. The files of 86 HIV-1-infected mothers and their newborns referred to a Public Hospital from March 2002 to March 2007 were analyzed. The HIV-1-RNA viral load of the newborns was determined by bDNA. The HIV-1 vertical-transmission rate was 4.6%. Children that were born in the pre-term period and breastfed were at a higher risk of HIV-1 infection (p = 0.005 and p = 0.017 respectively) than children born at term and not breastfed. Prophylactic therapy with zidovudine after birth for newborns was associated with a lower risk of infection (p = 0.003). The number of newborns weighing < 2,500 g was significantly higher for infected children (p = 0.008) than for non-infected newborns. About 22.9% of mothers did not know the HIV-1 status of their newborns eight months after delivery. The study suggests that it is necessary to increase the identification of HIV-1 infection in pregnant women and their newborns as well as to offer and explain the benefits of ARV prophylaxis.

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Section: Discussionmentioning

confidence: 73%

“…Infectious diseases account for nearly 90% of early childhood deaths in developing countries (MUSSI-PINHATA et al, 2007). In this study, 93% of infants received trimethoprim/sulfamethoxazole in the neonatal period for prophylaxis against Pneumocystis jiroveci pneumonia.…”

Section: Discussionmentioning

confidence: 89%

HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

Prestes-Carneiro

Spir

Ribeiro

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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“…Infants with perinatally transmitted HIV infection are at a high risk of repeated infections, malnutrition and early death. Recent studies have shown that even those infants born to HIV infected mothers (HIV exposed infants) who remain uninfected, have a high morbidity, mortality and prevalence of growth failure [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Outcome of HIV Exposed Infants: Experience of a Regional Pediatric Center for HIV in North India

et al. 2011

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“…Programs for vertical transmission prevention of HIV (VTP) have reduced vertical infection to well below 10% (5), therefore nearly 2 million HIV-exposed but uninfected (HEU) infants are born annually. Recent evidence indicates that HEU infants are at a higher risk of infectious morbidity and mortality than their HIV-unexposed, uninfected (HUU) peers (6)(7)(8)(9)(10)(11)(12). The underlying reason(s) for this phenomenon are still unclear but are possibly multifactorial; severity of maternal HIV disease (13), avoidance of breastfeeding (14)(15)(16), and differences in microbial exposures (17) have all been postulated.…”

mentioning

confidence: 99%

Antibody Responses to Vaccination among South African HIV-Exposed and Unexposed Uninfected Infants during the First 2 Years of Life

Reikie

Naidoo

Ruck

et al. 2013

Clin Vaccine Immunol

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e HIV-exposed but uninfected (HEU) infants born to HIV-infected mothers from areas in the world with a high burden of infectious disease suffer higher infectious morbidity and mortality than their HIV unexposed uninfected (HUU) peers. Vaccination provides protection from infection. The possibility exists that altered response to vaccination contributes to the higher rate of infection in HEU than in HUU infants. While short-term, cross-sectional studies support this notion, it is unclear whether or not HEU infants develop long-term protective immune responses following the WHO extended program on immunization (EPI).Vaccine-specific antibody responses were compared between HEU and HUU infants from 2 weeks until 2 years of age in a longitudinal South African cohort. Total IgG and antibodies specific for Bordetella pertussis, Haemophilus influenzae type b (Hib), tetanus toxoid, hepatitis B virus (HepB), and measles virus were measured at multiple time points throughout the first 2 years of life. Prevaccine antibodies (maternal antibodies passively acquired) specific for tetanus were lower in HEU than in HUU infants, while prevaccine antibodies to HepB were higher in HEU than in HUU infants. Both groups responded similarly to tetanus, Hib, and HepB vaccination. HEU demonstrated stronger pertussis vaccine responses, developing protective titers 1 year earlier than HUU patients, and maintained higher anti-tetanus titers at 24 months of age. Vaccine-induced antibodies to measles virus were similar in both groups at all time points. Our results suggest that the current EPI vaccination program as practiced in South Africa leads to the development of vaccine-specific antibody responses that are equivalent in HEU and HUU infants. However, our data also suggest that a large fraction of both HEU and HUU South African infants have antibody titers for several infectious threats that remain below the level of protection for much of their first 2 years of life.

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Infectious Disease Morbidity Among Young HIV-1–Exposed But Uninfected Infants in Latin American and Caribbean Countries: The National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study

Abstract: Close monitoring of HIV-1-exposed infants, especially those who are anemic at birth or whose mothers have more-advanced HIV-1 disease or who smoked during pregnancy, remains important.

Cited by 85 publications

References 32 publications

HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

HIV-1-mother-to-child transmission and associated characteristics in a public maternity unit in Presidente Prudente, Brazil

Outcome of HIV Exposed Infants: Experience of a Regional Pediatric Center for HIV in North India

Antibody Responses to Vaccination among South African HIV-Exposed and Unexposed Uninfected Infants during the First 2 Years of Life

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