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Survival of infants in the context of prevention of mother to child HIV transmission in South Africa
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
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2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 5, 694-698 p.Article in journal (Refereed) Published
Abstract [en]

Aim: We sought to study the survival of newborn children according to HIV status of the mother, that of the child and the timing of infection. Methods: This is a prospective cohort study of 883 mothers (665 HIV-positive and 218 HIV-negative) and their infants. Data were collected using semi-structured questionnaires during home visits between the antenatal period and 36 weeks post-delivery. Infant HIV status was determined at 3, 24 and 36 weeks by HIV DNA PCR. Results: The majority (81.3%) of infected infants who died were infected by 3 weeks of age. Of the HIV-exposed infants who died, 19 (28.4%) died before 6 weeks and 38 (56.7%) died by 12 weeks. The hazard ratio (HR) of mortality at 36 weeks of age in HIV-infected infants compared with exposed but negative infants was 8.9 (95% CI: 6.7-11.8). There was no significant difference in 36 week survival rates between HIV-non-exposed and HIV-exposed but negative infants (HR: 0.7; 95% CI: 0.3-1.5). The infant being HIV-positive at age 3 weeks (HR: 32 95% CI: 14.0-73.1) and rural site (HR: 4.4 95% CI: 1.2-23.4) were the two independent risk factors for infant death amongst HIV-exposed infants. Conclusion: The prognosis for infants with early HIV infection was very poor in this cohort. A greater focus on prevention of early infection, earlier screening for HIV infection and access to antiretrovirals for eligible infants is recommended.

Place, publisher, year, edition, pages
2010. Vol. 99, no 5, 694-698 p.
Keyword [en]
Infant mortality, Mother to child transmission of HIV, Paediatric HIV
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-136683DOI: 10.1111/j.1651-2227.2009.01675.xISI: 000276034800015PubMedID: 20096027OAI: oai:DiVA.org:uu-136683DiVA: diva2:377421
Available from: 2010-12-14 Created: 2010-12-14 Last updated: 2017-12-11Bibliographically approved

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Chopra, MickeyDoherty, TanyaPersson, Lars-Åke

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