The effects of exposure to HIV in neonates at a referral hospital in South Africa

Abstract Background Fewer infants are infected with HIV through mother-to-child transmission, making HIV-exposed but uninfected (HEU) infants a growing population. HIV-exposure seems to affect immunology, early growth and development, and is associated with higher morbidity and mortality rates. Curr...

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Autores principales:	Helena Mellqvist, Robin T. Saggers, Anders Elfvin, Elisabet Hentz, Daynia E. Ballot
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HIV-exposed neonate HIV-exposed uninfected HIV-unexposed neonate HIV positive mother Neonatal mortality Neonatal morbidity Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/7ba221733c924f1195b946d5159bf468
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spelling	oai:doaj.org-article:7ba221733c924f1195b946d5159bf4682021-11-08T11:04:49ZThe effects of exposure to HIV in neonates at a referral hospital in South Africa10.1186/s12887-021-02969-61471-2431https://doaj.org/article/7ba221733c924f1195b946d5159bf4682021-11-01T00:00:00Zhttps://doi.org/10.1186/s12887-021-02969-6https://doaj.org/toc/1471-2431Abstract Background Fewer infants are infected with HIV through mother-to-child transmission, making HIV-exposed but uninfected (HEU) infants a growing population. HIV-exposure seems to affect immunology, early growth and development, and is associated with higher morbidity and mortality rates. Currently, there is a lack of information regarding the clinical effects of HIV-exposure during the neonatal period. Objectives To identify a possible difference in mortality and common neonatal morbidities in HEU neonates compared to HIV-unexposed neonates. Methods This was a retrospective, descriptive study of all neonates admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital between 1 January 2017 and 31 December 2018. HEU neonates were compared to HIV-unexposed neonates. Results There were 3236 neonates included, where 855 neonates were HEU. The HEU neonates had significantly lower birth weight and gestational age. The HEU neonates had higher rates of neonatal sepsis (19.8% vs 14.2%, OR 1.49, p < 0.001), specifically for late onset sepsis, and required more respiratory support. NCPAP and invasive ventilation was more common in the HEU group (36.3% vs 31.3% required NCPAP, p = 0.008, and 20.1% vs 15,0% required invasive ventilation, p < 0.001). Chronic lung disease was more common among HIV-exposed neonates (12.2% vs 8.7%, OR 1.46, p = 0.003). The difference in mortality rates between the study groups was not significant (10.8% of HEU neonates and 13.3% of HIV-unexposed). Conclusions HEU neonates had higher rates of neonatal sepsis, particularly late-onset sepsis, required more respiratory support and had higher rates of chronic lung disease. Mortality of HEU neonates was not different HIV-unexposed neonates.Helena MellqvistRobin T. SaggersAnders ElfvinElisabet HentzDaynia E. BallotBMCarticleHIV-exposed neonateHIV-exposed uninfectedHIV-unexposed neonateHIV positive motherNeonatal mortalityNeonatal morbidityPediatricsRJ1-570ENBMC Pediatrics, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV-exposed neonate HIV-exposed uninfected HIV-unexposed neonate HIV positive mother Neonatal mortality Neonatal morbidity Pediatrics RJ1-570
spellingShingle	HIV-exposed neonate HIV-exposed uninfected HIV-unexposed neonate HIV positive mother Neonatal mortality Neonatal morbidity Pediatrics RJ1-570 Helena Mellqvist Robin T. Saggers Anders Elfvin Elisabet Hentz Daynia E. Ballot The effects of exposure to HIV in neonates at a referral hospital in South Africa
description	Abstract Background Fewer infants are infected with HIV through mother-to-child transmission, making HIV-exposed but uninfected (HEU) infants a growing population. HIV-exposure seems to affect immunology, early growth and development, and is associated with higher morbidity and mortality rates. Currently, there is a lack of information regarding the clinical effects of HIV-exposure during the neonatal period. Objectives To identify a possible difference in mortality and common neonatal morbidities in HEU neonates compared to HIV-unexposed neonates. Methods This was a retrospective, descriptive study of all neonates admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital between 1 January 2017 and 31 December 2018. HEU neonates were compared to HIV-unexposed neonates. Results There were 3236 neonates included, where 855 neonates were HEU. The HEU neonates had significantly lower birth weight and gestational age. The HEU neonates had higher rates of neonatal sepsis (19.8% vs 14.2%, OR 1.49, p < 0.001), specifically for late onset sepsis, and required more respiratory support. NCPAP and invasive ventilation was more common in the HEU group (36.3% vs 31.3% required NCPAP, p = 0.008, and 20.1% vs 15,0% required invasive ventilation, p < 0.001). Chronic lung disease was more common among HIV-exposed neonates (12.2% vs 8.7%, OR 1.46, p = 0.003). The difference in mortality rates between the study groups was not significant (10.8% of HEU neonates and 13.3% of HIV-unexposed). Conclusions HEU neonates had higher rates of neonatal sepsis, particularly late-onset sepsis, required more respiratory support and had higher rates of chronic lung disease. Mortality of HEU neonates was not different HIV-unexposed neonates.
format	article
author	Helena Mellqvist Robin T. Saggers Anders Elfvin Elisabet Hentz Daynia E. Ballot
author_facet	Helena Mellqvist Robin T. Saggers Anders Elfvin Elisabet Hentz Daynia E. Ballot
author_sort	Helena Mellqvist
title	The effects of exposure to HIV in neonates at a referral hospital in South Africa
title_short	The effects of exposure to HIV in neonates at a referral hospital in South Africa
title_full	The effects of exposure to HIV in neonates at a referral hospital in South Africa
title_fullStr	The effects of exposure to HIV in neonates at a referral hospital in South Africa
title_full_unstemmed	The effects of exposure to HIV in neonates at a referral hospital in South Africa
title_sort	effects of exposure to hiv in neonates at a referral hospital in south africa
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7ba221733c924f1195b946d5159bf468
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The effects of exposure to HIV in neonates at a referral hospital in South Africa

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