Rates of Hospitalization and Infection-Related Hospitalization Among Human Immunodeficiency Virus (HIV)–Exposed Uninfected Children Compared to HIV-Unexposed Uninfected Children in the United States, 2007–2016
Author:
Labuda Sarah M1, Huo Yanling2, Kacanek Deborah2, Patel Kunjal23, Huybrechts Krista4, Jao Jennifer5, Smith Christiana6, Hernandez-Diaz Sonia2, Scott Gwendolyn7, Burchett Sandra8, Kakkar Fatima9, Chadwick Ellen G5, Van Dyke Russell B1, , Chadwick Ellen, Ann Sanders Margaret, Malee Kathleen, Hunter Scott, Shearer William, Paul Mary, McMullen-Jackson Chivon, Eser-Jose Ruth, Harris Lynnette, Purswani Murli, Mirza Baig Mahoobullah, Villegas Alma, Gaye-Robinson Lisa, Dia Cooley Jawara, Blood James, Garvie Patricia, Borkowsky William, Deygoo Sandra, Lewis Jennifer, Dieudonne Arry, Bettica Linda, Johnson Juliette, Surowiec Karen, Knapp Katherine, Utech Jill, Wilkins Megan, Russell-Bell Jamie, Rosario Nicolas, Angeli-Nieves Lourdes, Olivera Vivian, Kohlhoff Stephan, Dennie Ava, Kaye Jean, Van Dyke Russell, Craig Karen, Sirois Patricia, Hutto Cecelia, Hickman Paige, Marullo Dan, Spector Stephen A, Figueroa Veronica, Loughran Megan, Nichols Sharon, McFarland Elizabeth, Barr Emily, Kwon Christine, Glenny Carrie, Rathore Mobeen, Stowers Kristi, Mahmoudi Saniyyah, Maraqa Nizar, Almira Rosita, Hayani Karen, Richardson Lourdes, Smith Renee, Miller Alina, Scott Gwendolyn, Mogollon Maria, Fernandez Gabriel, Cuadra Anai, Frederick Toni, Davtyan Mariam, Vinas Jennifer, Morales-Avendano Guadalupe, Rodriguez Zoe M, Torres Lizmarie, Scalley Nydia
Affiliation:
1. Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana, USA 2. Center for Biostatistics in AIDS Research,Boston, Massachusetts, USA 3. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA 4. Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA 5. Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA 6. Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA 7. Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA 8. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA 9. Department of Pediatrics, Université de Montréal, Montreal, Canada
Abstract
Abstract
Background
Studies from multiple countries have suggested impaired immunity in perinatally human immunodeficiency virus (HIV)–exposed uninfected children (HEU), with elevated rates of all-cause hospitalization and infections. We estimated and compared the incidence of all-cause hospitalization and infection-related hospitalization in the first 2 years of life among HEU and HIV-unexposed uninfected children (HUU) in the United States. Among HEU, we evaluated associations of maternal HIV disease–related factors during pregnancy with risk of child hospitalization.
Methods
HEU data from subjects enrolled in the Surveillance Monitoring for Antiretroviral Therapy Toxicities Study (SMARTT) cohort who were born during 2006–2017 were analyzed. HUU comparison data were obtained from the Medicaid Analytic Extract database, restricted to states participating in SMARTT. We compared rates of first hospitalization, total hospitalizations, first infection-related hospitalization, total infection-related hospitalizations, and mortality between HEU and HUU using Poisson regression. Among HEU, multivariable Poisson regression models were fitted to evaluate associations of maternal HIV factors with risk of hospitalization.
Results
A total of 2404 HEU and 3 605 864 HUU were included in the analysis. HEU children had approximately 2 times greater rates of first hospitalization, total hospitalizations, first infection-related hospitalization, and total infection-related hospitalizations compared with HUUs. There was no significant difference in mortality. Maternal HIV disease factors were not associated with the risk of child infection or hospitalization.
Conclusions
Compared with HUU, HEU children in the United States have higher rates of hospitalization and infection-related hospitalization in the first 2 years of life, consistent with studies in other countries. Closer monitoring of HEU infants for infection and further elucidation of immune mechanisms is needed.
Funder
Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institute on Drug Abuse National Institute of Allergy and Infectious Diseases Office of AIDS Research National Institute of Mental Health National Institute of Neurological Disorders and Stroke National Institute on Deafness and Other Communication Disorders National Institute of Dental and Craniofacial Research National Cancer Institute National Institute on Alcohol Abuse and Alcoholism National Heart, Lung, and Blood Institute Harvard T. H. Chan School of Public Health Tulane University School of Medicine
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
28 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|