HIV-exposed infants

Abstract

Summary Each year over a million infants are born to HIV infected mothers though with scale up of prevention of mother to child transmission (PMTCT) interventions, only 210,000 of the 1.3 million infants born to mothers with HIV/AIDS in 2012 became infected. Current programmatic efforts directed at infants born to HIV-infected mothers are primarily focused on decreasing their risk of infection, but this emphasis on maternal interventions has meant follow-up of exposed infants has been poor. Programs are struggling to retain this population in care until the end of exposure, typically at the cessation of breastfeeding, between 12 and 24 months of age. But HIV exposure is a life-long condition that continues to impact the health and well-being of a child long after exposure has ended. A better understanding of the impact of HIV on exposed infants is needed and new programs and interventions must take into consideration the long-term health needs of this growing population. The introduction of lifelong treatment for all HIV-infected pregnant women is an opportunity to rethink how we provide services adapted for the long-term retention of mother-infant pairs.

The Influence of HIV and Schistosomiasis on Renal Function: A Cross-sectional Study among Children at a Hospital in Tanzania

“…Because the dates of maternal HIV infection and viral suppression were not known, we could not confirm the HIV-exposure status among HIV-uninfected control siblings, but we suspect that most if not all were exposed since they were born within ~5 years of their HIV-infected sibling. HIV exposure, even in the absence of infection, has been associated with multiple abnormalities that may affect the development and function of the kidney in childhood [ 29 – 31 ]. On the other hand, the high prevalence of renal dysfunction among controls could also reflect a high community prevalence of renal dysfunction among children, possibly related to the known high prevalence of schistosomiasis.…”

Impact of elevated maternal HIV viral load at delivery on T-cell populations in HIV exposed uninfected infants in Mozambique

“…The current recommendation of HAART for all HIV-infected pregnant women (the B+ option) is promising and will serve to reduce infant HIV exposure in Sub-Saharan Africa [ 50 ]. However, there will be a lag time until infant HIV exposure is eliminated in the region, thus elucidation of the clinical relevance of infant’s exposure to maternal HIV [ 20 , 51 - 53 ] and its impact on altered T-cell populations should remain a priority.…”

Altered Toll-Like Receptor-4 Response to Lipopolysaccharides in Infants Exposed to HIV-1 and Its Preventive Therapy

“…Progress in the prevention of mother-to-child transmission of HIV has led to a significant reduction of mother-to-child HIV transmission rate, increasing the population of HIV-exposed uninfected (HEU) infants ( 1 – 3 ). Indeed, HEU infants are a growing population with over a million infants born every year from HIV-infected mothers ( 2 ). Studies have shown that HEU infants are more vulnerable to diseases than infants born from HIV free mothers ( 4 – 8 ).…”