Rupérez María, González Raquel, Maculuve Sonia, Quintó Llorenç, López-Varela Elisa, Augusto Orvalho, Vala Anifa, Nhacolo Arsénio, Sevene Esperança, Naniche Denise, Menéndez Clara
aISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain bManhiça Health Research Center (CISM), Manhiça, Mozambique cConsorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
AIDS. 2017 Jul 17;31(11):1545-1553. doi: 10.1097/QAD.0000000000001499.
To assess morbidity and mortality in HIV-exposed uninfected (HEU) children to help guiding appropriate clinical care and effective preventive interventions.
This is a longitudinal study comparing two cohorts of children; one born to HIV-infected women and the other born to HIV-uninfected women.
We have analyzed prospectively obtained information on nutritional status, morbidity and mortality from 966 HEU and 909 HIV-unexposed infants followed up until their first 18 months of life at a referral health facility in southern Mozambique. Determinants for adverse health outcomes in HEU children were also assessed using multivariate logistic regression.
Increased incidence of hospital admissions (P = 0.0015), shorter survival in the first 18 months of life (P = 0.0510) and moderate and severe malnutrition (P = 0.0006 and 0.0014, respectively) were observed among HEU children compared with HIV-unexposed children. Incidence of outpatient attendance in HEU children was associated with being men, older age and the mother being on antiretroviral treatment. Among HEU children, those who were never breastfed, or who were weaned or were partially breastfed, had an increased incidence of hospital admissions compared with children who were exclusively breastfed.
Maternal HIV infection has important health consequences in non-HIV-infected children. As the prevalence of HIV-infected pregnant women is maintained and the proportion of HIV-infected children declines because of the scale-up of antiretroviral treatment during pregnancy and breastfeeding, more focus should be given to the health needs of HEU children to ensure that the post-2015 sustainable development goals are met.
评估暴露于HIV但未感染（HEU）儿童的发病率和死亡率，以帮助指导适当的临床护理和有效的预防干预措施。
这是一项纵向研究，比较两组儿童队列；一组为感染HIV的妇女所生，另一组为未感染HIV的妇女所生。
我们前瞻性地分析了在莫桑比克南部一家转诊医疗机构对966名HEU婴儿和909名未暴露于HIV的婴儿进行随访直至其18个月大时获得的有关营养状况、发病率和死亡率的信息。还使用多因素逻辑回归评估了HEU儿童不良健康结局的决定因素。
与未暴露于HIV的儿童相比，HEU儿童的住院率增加（P = 0.0015）、生命最初18个月的生存率较低（P = 0.0510）以及中度和重度营养不良发生率较高（分别为P = 0.00****和0.0014）。HEU儿童的门诊就诊率与男性、年龄较大以及母亲接受抗逆转录病毒治疗有关。在HEU儿童中，与纯母乳喂养的儿童相比，从未母乳喂养、已断奶或部分母乳喂养的儿童住院率增加。
母亲感染HIV对未感染HIV的儿童有重要的健康影响。由于感染HIV的孕妇患病率持续存在，且由于孕期和哺乳期扩大抗逆转录病毒治疗，感染HIV的儿童比例下降，因此应更加关注HEU儿童的健康需求，以确保实现2015年后可持续发展目标。
