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

Seth, Anju; Chandra, Jagdish; Gupta, Rakesh; Kumar, Praveen; Aggarwal, Varun; Dutta, A. K.

doi:10.1007/s12098-011-0532-8

Cited by 14 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With onset of HIV infection, the divergence in growth profile in our infants occurred within 4–6 weeks of life and persisted through one year of life. Other studies have noted differences occurring around 3 months of age [13,16,17], but most have noted the difference in growth between HIV-infected and uninfected occurring by one year of life [8,9,27]. LAZ score among infected infants in our study was lower by 0.35 at 6 months and 0.81 at 12 months.…”

Section: Discussioncontrasting

confidence: 65%

See 1 more Smart Citation

Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India

et al. 2012

View full text Add to dashboard Cite

BackgroundIndia has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist.MethodsWe used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting.ResultsAmong 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p< 0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4–6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with non-significant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 < 250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting.ConclusionBaseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants.Trial RegistrationNCT00061321

show abstract

Section: Discussioncontrasting

confidence: 65%

“…In a retrospective study of 162 HIV-exposed infants at a Regional Pediatric Center for HIV in Delhi, prevalence of wasting and stunting was 50.5% and 48.8%, respectively [27]. While our prevalence of stunting was comparable to that in this study, the wasting was lower in our study.…”

Section: Discussioncontrasting

confidence: 46%

Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Four studies reported on percentages of children who died, were lost to follow-up/defaulted or transferred out before starting ART [13]–[16], and one study reported the proportion of patients lost to follow-up [17]. A small study of 24 children reported on the proportion of children who died, with no children lost to follow-up [18]. The estimates ranged between 3.2% and 45.8% for mortality, 0.0% and 37% for loss to follow-up and 3.4% and 4.6% for transfer out ( Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Different eligibility criteria will influence the number of people deemed eligible for ART initiation while for children in advanced clinical stage it was not necessary to measure CD4 cells. Apart from two studies [12], [18] the follow-up ended before the new guidelines were published. Our study could thus not determine the impact of the change in guidelines on retention in care.…”

Section: Discussionmentioning

confidence: 99%

Retention in Care of HIV-Infected Children from HIV Test to Start of Antiretroviral Therapy: Systematic Review

et al. 2013

View full text Add to dashboard Cite

BackgroundIn adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined.MethodsWe searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate.ResultsEight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years.ConclusionMost children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings.

show abstract

“…The risk of transmission increases with the duration of breast feeding, although in a nonlinear fashion. [5] Antiretroviral prophylaxis given soon after birth to all HIV exposed infants is effective in reducing MTCT which forms the basis of post exposure prophylaxis strategy. Infant ARV prophylaxis is also highly effective in reducing transmission through breast milk.…”

Section: Introductionmentioning

confidence: 99%

The Benefits of New ARV Prophylaxis in Infants Who are on Exclusive Breast Feeding in Reducing the Risk of Mother to Child Transmission

Hamsa¹,

Naidu

et al. 2019

AJCPN

View full text Add to dashboard Cite

Background: Antiretroviral prophylaxis given soon after birth to all HIV exposed infants is effective in reducing MTCT which forms the basis of post exposure prophylaxis strategy. Infant ARV prophylaxis is also highly effective in reducing transmission through breast milk. Subjects and Methods: All mothers were counseled regarding advantages and disadvantages of both exclusive breast feeding and mixed feeding and was started on EBF on their choice. Babies were followed up at birth, 4weeks, 6weeks, 10weeks, 14weeks and monthly thereafter until 6 months of age and during every visit detailed history and clinical examination was performed and entered in preformed proforma. HIV status was evaluated at 6weeks and 6 months of life by direct blood spot for HIV-1 DNA PCR by ICTC and if it was positive it was confirmed by whole blood sample for HIV-1 DNA PCR at ART Centre. Results: At the end of 6 months, most common clinical morbidity noticed in HIV exposed exclusively breast fed infants was clinical pallor in 4(19.0%), followed by URTI, splenomegaly in 2(9.5%), and hepatomegaly, loose stools, oral thrush, severe acute malnutrition, and microcephaly was observed in 1(4.8%) babies. Conclusion: The breast milk of HIV-infected women may confer protection against common infant pathogens.

show abstract

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

Cited by 14 publications

References 20 publications

Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India

Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India

Retention in Care of HIV-Infected Children from HIV Test to Start of Antiretroviral Therapy: Systematic Review

The Benefits of New ARV Prophylaxis in Infants Who are on Exclusive Breast Feeding in Reducing the Risk of Mother to Child Transmission

Contact Info

Product

Resources

About