Maternal perinatal HIV infection tied to increased infectious morbidity in infants
The risk of infectious cause hospitalizations (ICH) is elevated in HIV-exposed uninfected (HEU) infants born to women living with perinatally-acquired HIV (PHIV), according to a study.
Of the 205 infants evaluated for ICH, 28 were HEU born to PHIV women (HEU-P), 112 were HEU born to non-PHIV women (HEU-N) and 65 were unexposed to HIV (HUU). PHIV women were younger than NPHIV and HIV-uninfected women (median age, 22 vs 29 and 23 years, respectively; p<0.01).
At least one ICH event occurred in 21 percent of HEU-P, 4 percent of HEU-N and 12 percent of HUU infants (p<0.01) in the first year of life. After adjusting for confounders, ICH risk was increased in HEU-P compared with HEU-N infants (adjusted odds ratio [aOR], 7.45; 95 percent CI, 1.58–35.04).
Such association persisted in subgroup analysis of HEU infants, excluding HUU infants, after adjustment for maternal lCD4 and HIV RNA level (aOR, 10.24; 1.66–63.31).
“Differences in intrauterine environments, social factors or access to care may be important factors to assess in future larger studies,” the authors said.
In this study, the authors assessed ICH prevalence during the first year of life among HEU-P, HEU-N and HUU infants in a US tertiary care centre. Maternal HIV status was categorized as follows: PHIV, NPHIV and HIV-uninfected. The association between maternal HIV status and infant ICH was examined using the Generalized Estimating Equation models.
“The ageing population of females with PHIV are having their own children. HEU-N infants experience higher infectious morbidity compared with HUU infants,” the authors noted.