Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis

Newell, Marie‐Louise; Coovadia, Hoosen M.; Cortina-Borja, Marjo; Rollins, Nigel; Gaillard, Philippe; Dabis, François

doi:10.1016/s0140-6736(04)17140-7

Cited by 1,023 publications

(831 citation statements)

References 29 publications

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“…Many of them are born to women who were not diagnosed with HIV, did not initiate ART, discontinued ART or adhered poorly to treatment [7–9]. Infants and young children living with HIV are at a very high risk of mortality: every second untreated HIV-infected child dies before the age of 2 years [10,11]. It is therefore crucial that HIV-positive children are diagnosed and treated soon after infection [10–12].…”

Section: Introductionmentioning

confidence: 99%

“…Infants and young children living with HIV are at a very high risk of mortality: every second untreated HIV-infected child dies before the age of 2 years [10,11]. It is therefore crucial that HIV-positive children are diagnosed and treated soon after infection [10–12]. To ensure timely HIV diagnosis and access to ART, the WHO recommends that children born to HIV-positive women (HIV-exposed children) are regularly followed-up and tested for HIV [5,12].…”

Section: Introductionmentioning

confidence: 99%

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HIV transmission and retention in care among HIV‐exposed children enrolled in Malawi's prevention of mother‐to‐child transmission programme

Haas

Oosterhout

Tenthani

et al. 2017

Journal of the International AIDS Society

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Introduction: In Malawi, HIV-infected pregnant and breastfeeding women are offered lifelong antiretroviral therapy (ART) regardless of CD4 count or clinical stage (Option B+). Their HIV-exposed children are enrolled in the national prevention of mother-to-child transmission (PMTCT) programme, but many are lost to follow-up. We estimated the cumulative incidence of vertical HIV transmission, taking loss to follow-up into account. Methods: We abstracted data from HIV-exposed children enrolled into care between September 2011 and June 2014 from patient records at 21 health facilities in central and southern Malawi. We used competing risk models to estimate the probability of loss to follow-up, death, ART initiation and discharge, and used pooled logistic regression and inverse probability of censoring weighting to estimate the vertical HIV transmission risk. Results: A total of 11,285 children were included; 9285 (82%) were born to women who initiated ART during pregnancy. At age 30 months, an estimated 57.9% (95% CI 56.6–59.2) of children were lost to follow-up, 0.8% (0.6–1.0) had died, 2.6% (2.3–3.0) initiated ART, 36.5% (35.2–37.9) were discharged HIV-negative and 2.2% (1.5–2.8) continued follow-up. We estimated that 5.3% (95% CI 4.7–5.9) of the children who enrolled were HIV-infected by the age of 30 months, but only about half of these children (2.6%; 95% CI 2.3–2.9) were diagnosed. Conclusions: Confirmed mother-to-child transmission rates were low, but due to poor retention only about half of HIV-infected children were diagnosed. Tracing of children lost to follow-up and HIV testing in outpatient clinics should be scaled up to ensure that all HIV-positive children have access to early ART.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HIV transmission and retention in care among HIV‐exposed children enrolled in Malawi's prevention of mother‐to‐child transmission programme

Haas

Oosterhout

Tenthani

et al. 2017

Journal of the International AIDS Society

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show abstract

“…Of these, less than 10% receive the ART they require [89]. Amongst these patients, one in three children will demise before one year of age, from various causes, including serious bacterial infection [90]. HIV-infected children are at a significantly higher risk of developing bacteremic pneumonia than their HIV-negative counterparts [91].…”

Section: Hib Vaccination and Hiv-1 Populationsmentioning

confidence: 99%

Haemophilus influenzae type b conjugate vaccines – A South African perspective

Visser

Hoosen

2012

Vaccine

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“…1 Without treatment, an estimated one-third of infants will die before their first birthday and half before the age of two. 19 Recent analysis has shown that infants infected perinatally are at particular risk of death from 2-6 months of life. Cotrimoxazole, a highly effective antibiotic for preventing pneumonia and other opportunistic infections, and early paediatric antiretroviral treatment are fundamental for prolonging the lives of many infected infants.…”

Section: Global Progress On Paediatric Hiv Care and Treatment 2005mentioning

confidence: 99%

“…But given that about a third of HIV positive infants die by 12 months and 50% by two years, it is unacceptable to wait until 18 months to perform a diagnostic HIV test in children. 19 Early diagnosis through virology testing is still not widely available in most low-and middleincome countries. In general, PCR tests are considered the gold standard for early diagnostic testing.…”

Section: Paediatric Diagnosticsmentioning

confidence: 99%

Global Progress in PMTCT and Paediatric HIV Care and Treatment in Low-and Middle-Income Countries in 2004–2005

Luo¹,

Akwara²,

Ngongo³

et al. 2007

Reproductive Health Matters

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Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis

Cited by 1,023 publications

References 29 publications

HIV transmission and retention in care among HIV‐exposed children enrolled in Malawi's prevention of mother‐to‐child transmission programme

HIV transmission and retention in care among HIV‐exposed children enrolled in Malawi's prevention of mother‐to‐child transmission programme

Haemophilus influenzae type b conjugate vaccines – A South African perspective

Global Progress in PMTCT and Paediatric HIV Care and Treatment in Low-and Middle-Income Countries in 2004–2005

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