NDLI: Lower respiratory tract infections among human immunodeficiency virus-exposed, uninfected infants.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mussi-Pinhata, Marisa M. Motta, Fabrizio Freimanis-Hance, Laura de Souza, Ricardo Szyld, Edgardo Succi, Regina C. M. Christie, Celia D. C. Rolon, Maria J. Ceriotto, Mariana Read, Jennifer S.
Spatial Coverage	Argentina Brazil
Description	Country affiliation: Brazil Author Affiliation: Mussi-Pinhata MM ( Faculty of Medicine of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto, SP, Brazil. mmmpinha@fmrp.usp.br)
Abstract	OBJECTIVES: To evaluate whether maternal HIV disease severity during pregnancy is associated with an increased likelihood of lower respiratory tract infections (LRTIs) in HIV-exposed, uninfected infants. METHODS: HIV-exposed, uninfected, singleton, term infants enrolled in the NISDI Perinatal Study, with birth weight >2500g were followed from birth until 6 months of age. LRTI diagnoses, hospitalizations, and associated factors were assessed. RESULTS: Of 547 infants, 103 (18.8%) experienced 116 episodes of LRTI (incidence=0.84 LRTIs/100 child-weeks). Most (81%) episodes were bronchiolitis. Forty-nine (9.0%) infants were hospitalized at least once with an LRTI. There were 53 hospitalizations (45.7%) for 116 LRTI episodes. None of these infants were breastfed. The odds of LRTI in infants whose mothers had CD4% <14 at enrollment were 4.4 times those of infants whose mothers had CD4% ≥29 (p=0.003). The odds of LRTI in infants with a CD4+ count (cells/mm(3)) <750 at hospital discharge were 16.0 times those of infants with CD4+ ≥750 (p=0.002). Maternal CD4+ decline and infant hemoglobin at the 6-12 week visit were associated with infant LRTIs after 6-12 weeks and before 6 months of age. CONCLUSIONS: Acute bronchiolitis is common and frequently severe among HIV-exposed, uninfected infants aged 6 months or less. Lower maternal and infant CD4+ values were associated with a higher risk of infant LRTIs. Further understanding of the immunological mechanisms of severe LRTIs is needed.
File Format	HTM / HTML
ISSN	12019712
e-ISSN	18783511
DOI	10.1016/j.ijid.2010.01.006
Journal	International Journal of Infectious Diseases
Issue Number	Suppl 3
Volume Number	14
Language	English
Publisher	Elsevier
Publisher Date	2010-09-01
Publisher Place	Canada
Access Restriction	Open
Subject Keyword	Discipline Communicable Diseases Hiv Infections Immunology Pregnancy Complications, Infectious Prenatal Exposure Delayed Effects Respiratory Tract Infections Etiology Bronchiolitis Cd4 Lymphocyte Count Cohort Studies Transmission Infant Infant, Newborn Infectious Disease Transmission, Vertical Pregnancy Prospective Studies Risk Factors Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Microbiology (medical)

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