Mortality in HIV-Infected and Uninfected Children of HIV-Infected and Uninfected Mothers in Rural Uganda

Brahmbhatt, Heena; Kigozi, Godfrey; Wâbwire-Mângen, Fred; Serwadda, David; Lutalo, Tom; Nalugoda, Fred; Sewankambo, Nelson; Kiduggavu, Mohamed; Wawer, Maria J.; Gray, Ronald H.

doi:10.1097/01.qai.0000188122.15493.0a

Cited by 164 publications

(165 citation statements)

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“…Cohort studies from other sub-Saharan countries have shown that, before the availability of ART, HEU children had a higher mortality risk than HIV-unexposed children [4,6,29]. However, reports on mortality in HEU and HIVunexposed children in the ARTera are scarce, and results are heterogeneous [19,[30][31][32][33].…”

Section: Discussionmentioning

confidence: 83%

“…Direct or indirect HIV exposure in utero, intra partum or during breastfeeding may confer risks even in the absence of infection. Several studies have described increased mortality and enhanced risk of poor health and growth outcomes in HEU compared with HIV-unexposed children [4][5][6][7][8][9][10][11]. However, the nature of the vulnerability of the HEU children is not entirely clear.…”

Section: Introductionmentioning

confidence: 97%

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Maternal HIV infection is an important health determinant in non-HIV-infected infants

Rosario

González

Maculuve

et al. 2017

Aids

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Objective: To assess morbidity and mortality in HIV-exposed uninfected (HEU) children to help guiding appropriate clinical care and effective preventive interventions.Design: This is a longitudinal study comparing two cohorts of children; one born to HIV-infected women and the other born to HIV-uninfected women. Methods:We have analyzed prospectively obtained information on nutritional status, morbidity and mortality from 966 HEU and 909 HIV-unexposed infants followed up until their first 18 months of life at a referral health facility in southern Mozambique. Determinants for adverse health outcomes in HEU children were also assessed using multivariate logistic regression.Results: Increased incidence of hospital admissions (P ¼ 0.0015), shorter survival in the first 18 months of life (P ¼ 0.0510) and moderate and severe malnutrition (P ¼ 0.0006 and 0.0014, respectively) were observed among HEU children compared with HIVunexposed children. Incidence of outpatient attendance in HEU children was associated with being men, older age and the mother being on antiretroviral treatment. Among HEU children, those who were never breastfed, or who were weaned or were partially breastfed, had an increased incidence of hospital admissions compared with children who were exclusively breastfed. Conclusion:Maternal HIV infection has important health consequences in non-HIVinfected children. As the prevalence of HIV-infected pregnant women is maintained and the proportion of HIV-infected children declines because of the scale-up of antiretroviral treatment during pregnancy and breastfeeding, more focus should be given to the health needs of HEU children to ensure that the post-2015 sustainable development goals are met.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 97%

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Rosario

González

Maculuve

et al. 2017

Aids

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“…It others setting very high mortality rate where found in infants who were not on ARV compared to those receiving ARV treatment (14). Death occurred in our study at a median age of 7 months; HIV infection increased the death rate before the age of 2 years considerably (39,40). The survival rate was low (43.3%) in children who were not treated, against 84.3% in those on ARV treatment.…”

Section: Discussionmentioning

confidence: 55%

Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study

et al. 2016

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Background: Rapid progressors are exposed to HIV infection at an early stage of life, and the prognosis is poor without treatment. Reducing the proportion of infants who are rapid progressors, require strengthening strategies to achieve the highest level of performance for the PMTCT program.Methods: This was a retrospective study carried out on HIV infected infants aged less than 12 months, clinically classified stage 4 (WHO) or having CD4 count <25%. We described maternal and obstetrical characteristics of HIV-infected rapid progressors using univariate and bivariate analysis. Patients' survival was monitored from the inclusion time to the end of the study. We then estimated their probability of survival with or without anti-retroviral (ARV) treatment from birth using the Kaplan-Meier method.Results: The characteristics of the mothers of the 150 rapid progressors infants we included were: low level of education (OR=3.87; P=0.016), CD4 count less than 200/mm 3 (OR=43.3; P=0.000), absence of ARV prophylaxis (OR=6.02; P=0.043), or treatment with HAART (OR=5.74; P=0.000) during pregnancy. In the children, the most important findings were lack of co-trimoxazole prophylaxis (OR=11.61; P=0.000) and antiretroviral prophylaxis (OR=2.70; P=0.0344). The survival rate was 84.3% in infants who were receiving HAART as opposed to 43.3% in those who were not (P<0.05).Conclusions: HIV infected women who are eligible should start antiretroviral treatment prior to a pregnancy, in order to improve their immunological status. This measure associated to cotrimoxazole prophylaxis and ART could improve their survival.

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“…1 The progression of HIV infection in children is very aggressive and many children die during their young age. 2 In India the estimated number of children under 15 years is 4%. A collaborative study on the growth patterns of HIV infected (184) and uninfected (1403) children.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Spirulina Supplement and Selected Yogasanas on Quality of Life of Children With Hiv Infection

Prabhavathi¹,

Nalini²,

Sethu³

2016

Int. J. Res. Ayurveda Pharm.

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The present study was aimed to evaluate the effectiveness of spirulina supplement and selected yogasanas on quality of life of children with HIV infection. Two hundred children with HIV infection aged between 5 and 18 years belong to both sexes participated in the study hundred children were chosen for both experimental and control groups. Commercially available and ISO certified spirulina food supplement was used in the study. Selected yogasnas such as tadasana (standing pose), trikonasana (triangle pose), padmasana (lotus pose), vajrasana, yogamudra and shavasana (corpse pose) were practiced by the participants under supervision of experts. The domains of quality of life scores also showed a significant change in all comparisons of pretest and posttests of experimental group with the control group and between the experimental and control group of both parent reported scores and self reported scores except the self reported psychosocial summary scores in post test II. The interventions that the spirulina supplement and selected yogasanas would have had a significant impact on the physiological parameters and the quality of life of children with HIV infection/AIDS.

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Mortality in HIV-Infected and Uninfected Children of HIV-Infected and Uninfected Mothers in Rural Uganda

Abstract: More than half of HIV-infected infants died at less than 2 years of age. Therefore, ART may need to be initiated earlier in HIV-infected African children.

Cited by 164 publications

References 11 publications

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study

Effectiveness of Spirulina Supplement and Selected Yogasanas on Quality of Life of Children With Hiv Infection

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