Human immunodeficiency virus (HIV)-exposed uninfected (HEU)
infants are a growing population in sub-Saharan Africa, with higher morbidity
and mortality than HIV-unexposed infants. HEU infants may experience increased
morbidity due to breastfeeding avoidance.
We sought to describe the burden and identify predictors of
hospitalization among HEU infants in the first year of life.
Using a retrospective cohort of HIV-infected mothers and
their HEU infants in Nairobi, Kenya, we identified infants who were
HIV-uninfected at birth and were followed monthly until their last negative HIV
test, death, loss to follow-up, or study exit at 1 year of age. Incidence,
timing, and reason for hospitalization was assessed overall as well as
stratified by feeding method. Predictors of first infectious disease
hospitalization were identified using competing risk regression, with HIV
acquisition and death as competing risks.
Among 388 infants, 113 hospitalizations were reported
(35/100 infant-years [the combined years of observation contributed by all
infants in the study]; 95% confidence interval [CI], 29-42). Ninety
hospitalizations were due to 1 or more infectious diseases (26/100
infant-years; 95% CI, 21-32)-primarily pneumonia (n = 40), gastroenteritis (n =
17), and sepsis (n = 14). Breastfeeding was associated with decreased risk of
infectious disease hospitalization (subhazard ratio = 0.39; 95% CI, 0.24-0.64),
as was time-updated nutrition status (subhazard ratio = 0.73; 95% CI,
0.61-0.89). Incidence of infectious disease hospitalization among formula-fed
infants was 51/100 infant-years (95% CI, 37-70) compared to 19/100 infant-years
(95% CI, 14-25) among breastfed infants.
Among HEU infants, breastfeeding and nutrition status were
associated with reduced hospitalization during the first year of life.
Via: http://goo.gl/5ftDNE Purchase
full article at:
By:
- 1Department of Epidemiology, University of Washington, Seattle, WA, USA
- 2Department of Global Health, University of Washington, Seattle, WA, USA.
- 3Department of Paediatrics & Child Health, University of Nairobi, Nairobi, Kenya.
- 4Kenya Medical Research Institute, Nairobi, Kenya.
- 5Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya.
- 6Department of Epidemiology, University of Washington, Seattle, WA, USA Department of Global Health, University of Washington, Seattle, WA, USA Department of Medicine, University of Washington, Seattle, WA, USA Department of Pediatrics, University of Washington, Seattle, WA, USA.
More at: https://twitter.com/hiv_insight
No comments:
Post a Comment