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

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dc.contributor.authorMussi-Pinhata, Marisa M.
dc.contributor.authorMotta, Fabrizio
dc.contributor.authorFreimanis-Hance, Laura
dc.contributor.authorSouza, Ricardo de
dc.contributor.authorSzyld, Edgardo
dc.contributor.authorSucci, Regina Célia de Menezes [UNIFESP]
dc.contributor.authorChristie, Celia D. C.
dc.contributor.authorRolon, Maria J.
dc.contributor.authorCeriotto, Mariana
dc.contributor.authorRead, Jennifer S.
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionWESTAT Corp
dc.contributor.institutionUniv Caxias Sul
dc.contributor.institutionHosp Diego Paroissien
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv W Indies
dc.contributor.institutionHosp Juan Fernandez
dc.contributor.institutionHosp Agudos Dra Cecilia Grierson
dc.contributor.institutionNICHD
dc.date.accessioned2016-01-24T14:05:21Z
dc.date.available2016-01-24T14:05:21Z
dc.date.issued2010-09-01
dc.description.abstractObjectives: 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 >2500 g 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. (C) 2010 International Society for Infectious Diseases. Published by Elsevier B.V. All rights reserved.en
dc.description.affiliationUniv São Paulo, Fac Med Ribeirao Preto, BR-14049900 Ribeirao Preto, SP, Brazil
dc.description.affiliationWESTAT Corp, Rockville, MD 20850 USA
dc.description.affiliationUniv Caxias Sul, Rio Grande Do Sul, Brazil
dc.description.affiliationHosp Diego Paroissien, Buenos Aires, DF, Argentina
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUniv W Indies, Kingston 7, Jamaica
dc.description.affiliationHosp Juan Fernandez, Buenos Aires, DF, Argentina
dc.description.affiliationHosp Agudos Dra Cecilia Grierson, Buenos Aires, DF, Argentina
dc.description.affiliationNICHD, Pediat Adolescent & Maternal AIDS Branch, CRMC, NIH,DHHS, Bethesda, MD USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, EPM, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNICHD
dc.description.sponsorshipIDNICHD: N01-HD-3-3345
dc.description.sponsorshipIDNICHD: HHSN267200800001C
dc.description.sponsorshipIDNICHD: N01-DK-8-0001
dc.format.extentE176-E182
dc.identifierhttp://dx.doi.org/10.1016/j.ijid.2010.01.006
dc.identifier.citationInternational Journal of Infectious Diseases. Oxford: Elsevier B.V., v. 14, p. E176-E182, 2010.
dc.identifier.doi10.1016/j.ijid.2010.01.006
dc.identifier.fileWOS000282643000035.pdf
dc.identifier.issn1201-9712
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32835
dc.identifier.wosWOS:000282643000035
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofInternational Journal of Infectious Diseases
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectHIV-exposeden
dc.subjectInfancyen
dc.subjectInfectionsen
dc.subjectLatin Americaen
dc.titleLower respiratory tract infections among human immunodeficiency virus-exposed, uninfected infantsen
dc.typeinfo:eu-repo/semantics/article
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