Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/37509
Title: Lower respiratory tract infections among human immunodeficiency virus-exposed, uninfected infants
Authors: Mussi-Pinhata, Marisa M.
Motta, Fabrizio
Freimanis-Hance, Laura
Souza, Ricardo de
Szyld, Edgardo
Succi, Regina C. M.
Christie, Celia D. C.
Rolon, Maria J.
Ceriotto, Mariana
Read, Jennifer S.
NISDI Perinatal Study Group
Affilliation: University of São Paulo. Faculty of Medicine of Ribeirão Preto. Ribeirão Preto, SP, Brazil.
University of São Paulo. Faculty of Medicine of Ribeirão Preto. Ribeirão Preto, SP, Brazil.
Westat. Rockville, MD, USA.
Universidade de Caxias do Sul. Caxias do Sul, RS, Brasil.
Hospital Diego Paroissien. Buenos Aires, Argentina.
Federal University of São Paulo. São Paulo, SP, Brazil.
University of the West Indies. Kingston, Jamaica.
Hospital Juan Fernandez. Buenos Aires, Argentina.
Hospital de Agudos Dra. Cecilia Grierson. Buenos Aires, Argentina.
National Institutes of Health. Pediatric, Adolescent, and Maternal AIDS Branch. Bethesda, MD, USA
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 ≥ 2500 grams were followed from birth until six months of age. LRTI diagnoses, hospitalizations, and associated factors were assessed. Results: Of 547 infants, 103 (18.8%) experienced 116 episodes of LRTIs (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 were 4.4 times than that of those whose mothers had CD4%≥29 (p=0.003). The odds of LRTI were 16.0 times that of infants with a CD4+ count [cells/mm3] < 750 at birth compared to those 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 six months of age. Conclusions: Acute bronchiolitis is common and frequently severe among HIV-exposed, uninfected infants aged six 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.
Keywords: HIV-exposed
Infancy
Infections
Latin America
Issue Date: 2010
Publisher: Elsevier
Citation: MUSSI-PINHATA, Marisa M. et al. Lower respiratory tract infections among human immunodeficiency virus-exposed, uninfected infants. International Journal of Infectious Diseases, v. 14, suppl. 3, p. 1-16, Sept. 2010.
Description: Beatriz Grinsztejn; Valdilea Veloso. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. NISDI Perinatal Study Group Principal investigators, co-principal investigators, study coordinators, coordinating center representatives, and NICHD staffinclude: Argentina: Buenos Aires: Marcelo H. Losso, Adriana S.Durán, Silvina Ivalo (Hospital General de Agudos Jose ́Marı ́a Ramos Mejía); Brazil: Belo Horizonte: Jorge Pinto, Victor Melo, Fabiana Kakehasi (Universidade Federal de Minas Gerais); Caxias do Sul: Ricardo da Silva de Souza, Nicole Golin, Sílvia Mariani Costamilan (Universidade de Caxias do Sul/Serviço Municipal de Infectologia);Nova Iguacu: Jose Pilotto, Beatriz Grinsztejn, Valdilea Veloso(Hospital Geral Nova de Iguacu - HIV Family Care Clinic); Porto Alegre: Ricardo da Silva de Souza, Breno Riegel Santos, Rita de Cassia Alves Lira (Universidade de Caxias do Sul/Hospital Conceição); Ricardo da Silva de Souza, Mario Peixoto, Elizabete Teles (Universidade de Caxias do Sul/Hospital Fêmina); Regis Kreitchmann, Debora Fernandes Coelho (Irmandade da Santa Casa de Misericordia de Porto Alegre); Ribeirão Preto: Marisa M. Mussi-Pinhata, Geraldo Duarte, Carolina Sales V. Macedo, Adriana A. Tiraboschi Bárbaro, Conrado Milani Coutinho (Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo); Rio de Janeiro: Ricardo Hugo S. Oliveira, Elizabeth S. Machado, Maria C. Chermont Sapia (Instituto de Puericultura e Pediatria Martagão Gesteira); Esau Custodio Joao, Leon Claude Sidi,Guilherme Amaral Calvet, Claudete Araújo Cardoso (Hospital dos Servidores do Estado); Sa ̃o Paulo: Regina Celia de Menezes Succi, Prescilla Chow Lindsey (Federal University of São Paulo); Peru: Lima: Jorge Alarcón (Instituto de Medicina Tropical ‘‘Daniel Alcides Carrión’’ – Sección de Epidemiologıa, UNMSM), Carlos Velásquez Vásquez (Instituto Nacional Materno Perinatal), César Gutiérrez Villafuerte (Instituto de Medicina Tropical ‘‘Daniel Alcides Carrión’’– Sección de Epidemiología, UNMSM); Data Management and Statistical Center: Yolanda Bertucci, Laura Freimanis Hance, René Gonin, D. Robert Harris, Roslyn Hennessey, James Korelitz, Margot Krauss, Sharon Sothern, Sonia K. Stoszek (Westat, Rockville, MD,USA); NICHD: Rohan Hazra, Lynne Mofenson, Jennifer S. Read, Heather Watts, Carol Worrell (Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
DOI: 10.1016/j.ijid.2010.01.006
ISSN: 1201-9712
Copyright: open access
Appears in Collections:INI - Artigos de Periódicos

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