HIV exposure does not worsen outcome in stage III necrotizing enterocolitis with current treatment protocols

Arnold, Marion; Moore, Samuel W.

doi:10.1016/j.jpedsurg.2011.11.047

Cited by 8 publications

(6 citation statements)

References 59 publications

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“…This study investigated infants who were diagnosed with stages 2 and 3 disease and found no difference in the clinical presentation of NEC between infants born to HIV-positive and HIVnegative mothers. This was consistent with findings by Karpelowsky et al 5 6 In contrast, Karpelowsky et al 5 and Chokoe et al 7 reported higher mortality from NEC in infants born to HIVpositive mothers than in those born to HIV-negative mothers.…”

Section: Discussionsupporting

confidence: 91%

“…The recording of these characteristics might have been inaccurate or incomplete. The strength was that a larger sample than those in previous similar studies [5][6][7]9 was used to investigate the association between NEC and HIV-exposure in infants.…”

Section: Who Studied Infants Who Hadmentioning

confidence: 99%

“…2,3 There is a paucity of studies on the risk factors associated with NEC in infants born in a setting where exposure to maternal HIV is prevalent. [5][6][7] Infants born to HIV-positive mothers may be more prone to infection and possibly develop NEC because of immunological deficiencies including that of cytokine production. 8 In addition, the antiretroviral zidovudine used to prevent mother-to-child transmission of HIV might increase the risk of NEC by inducing mitochondrial damage and dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…9 Karpelowsky et al 5 in Cape Town, South Africa found no difference in the rate of panintestinal necrosis between infants born to HIVpositive and HIV-negative mothers (4/22 and 3/48, respectively), consistent with findings of other investigators in Cape Town. 6,7 In South Africa in 2009, about 30% of pregnant women seeking antenatal care in public healthcare facilities were HIV-positive; 10 a large number of infants were therefore exposed to the virus and antiretroviral agents. The aim of this study was to determine factors associated with NEC in infants born in a public hospital in which HIV is prevalent.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for necrotising enterocolitis in an HIV-endemic region

Angura

Velaphi

2014

Paediatrics and International Child Health

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Section: Discussionsupporting

confidence: 91%

Section: Who Studied Infants Who Hadmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for necrotising enterocolitis in an HIV-endemic region

Angura

Velaphi

2014

Paediatrics and International Child Health

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“…39,40 Infants who receive human milk show a reduced incidence of NEC, compared to those receiving infant formula. 41 Numerous advantages of breast milk have been found over infant formula. These include the earlier achievement of full enteral feeding, the presence of active enzymes which enhance the maturation of the immature intestinal tract, and anti-infective agents which protect the neonate from infections.…”

Section: Necrotising Enterocolitismentioning

confidence: 99%

The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission

Niekerk

Blaauw

Kirsten

2014

South African Journal of Clinical Nutrition

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The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission IntroductionResearch, started over a century ago, on human milk oligosaccharides (HMOs) has focused predominantly on their prebiotic effects. Today it is known that the bifidogenic effects of HMOs are one of the many beneficial effects now being discovered. 1 In addition to providing a substrate for the growth of beneficial bacteria, HMOs also directly inhibit pathogens from adhering to the intestinal epithelia through their antiadhesive properties. 1 Recent data suggest that firstly, a relationship exists between the HMOs and the incidence of necrotising enterocolitis (NEC), 2,3 and secondly, they may have an influence on human immunodeficiency virus (HIV) transmission. 4 This article aims to describe the prebiotic and antiadhesive effects of HMOs, and how they could possibly prevent the development of NEC in the presence of HIV infection. Human milk oligosaccharidesHMOs 5,6 are complex carbohydrates that are highly abundant in breast milk, but not in infant formula. 7 Oligosaccharides are carbohydrates made up of 3-9 monosaccharide units. 5,6 The oligosaccharide concentration of human milk varies with gestational age, lactation duration, and from one mother to another. 6,8 HMOs reach the highest concentration in colostrum (20-25 g/l), and then decrease after roughly two weeks to approximately 5-20 g/l in mature breast milk. 1,6,[8][9][10][11] HMOs consists of five different monosaccharide units:• Glucose.• Galactose.• The sialic acid component, known as N-acetylglucosamine.• Fucose.• N-acteylneuaminic acid. 1,12 With a few exceptions, all HMOs contain lactose at their reducing end. They may be elongated (an enzymatic attachment) by the addition of β1-3-or β1-6-linked lacto-N-biose or N-acetyllacetosamine. The latter can be further extended by one or two disaccharides. Chain branching may occur at the β1-6 linkage. Branched lactose molecules may form both linear (para-HMOs) and branched structures (iso-HMOs). Furthermore, oligosaccharide chains can be fucosylated (also known as neutral oligosaccharides) in the α1-2, α1-3 or α1-4 linkage, or sialylated (also known as acidic oligosaccharides) in the α2-3 or α2-6 linkage. The ABH secretor (Se) status and Lewis (Le) blood group determines the HMO composition of a mother's breast milk. 1 The presence or absence of blood group substances (A, B and H) in the saliva and other body secretions is controlled by a gene on chromosome 19, the fucosyltransferase AbstractThe heavy burden of maternal human immunodeficiency virus (HIV) infection has resulted in a high prevalence of premature births, with an associated increase in the incidence of necrotising enterocolitis (NEC). NEC is a life-threatening inflammatory disease of the gastrointestinal tract that predominantly occurs in preterm infants. Human milk oligosaccharides (HMOs) are carbohydrate compounds which have been shown to have health-promoting effects through their bifidogenic and antiadhesiv...

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