Skip Navigation LinksHome > November 13, 2013 - Volume 27 - Issue 17 > Breastfeeding is associated with decreased pneumonia inciden...
doi: 10.1097/01.aids.0000432540.59786.6d
Epidemiology and Social: CONCISE COMMUNICATION

Breastfeeding is associated with decreased pneumonia incidence among HIV-exposed, uninfected Kenyan infants

Ásbjörnsdóttir, Kristjana H.a; Slyker, Jennifer A.b; Weiss, Noel S.a; Mbori-Ngacha, Dorothyd; Maleche-Obimbo, Elizabethd; Wamalwa, Daltond; John-Stewart, Gracea,b,c,e

Collapse Box


Objective: HIV-exposed uninfected (HEU) infants have higher infectious disease morbidity and mortality than unexposed infants. We determined the incidence and risk factors for pneumonia, a leading cause of infant mortality worldwide, in a cohort of HEU infants. Identifying predictors of pneumonia among HEU infants may enable early identification of those at highest risk.

Design: A retrospective cohort of HEU infants participating in a Kenyan perinatal HIV study, enrolled between 1999 and 2002.

Methods: Infants were followed monthly from birth to 12 months. Incidence of pneumonia diagnosed at monthly study visits, sick-child visits or by means of averbal autopsy was estimated with a 14-day window for new episodes. Cox proportional hazards regression was used to identify predictors of first pneumonia occurrence.

Results: Among 388 HEU infants with 328 person-years of follow-up, the incidence of pneumonia was 900/1000 child-years [95% confidence interval (CI) 800–1000]. Maternal HIV viral load at 32 weeks’ gestation [hazard ratio 1.2 (1.0–1.5) per log10 difference] and being underweight (weight-for-age Z-score <−2) at the previous visit [hazard ratio 1.8 (1.1–2.8)] were associated with increased risk of pneumonia. Breastfed infants had a 47% lower risk of pneumonia than those never breastfed [hazard ratio 0.53 (0.39–0.73)], independent of infant growth, maternal viral load and maternal CD4%. Breastfeeding was also associated with a 74% lower risk of pneumonia-related hospitalization [hazard ratio 0.26 (0.13–0.53)].

Conclusions: The incidence of pneumonia in this cohort of HEU infants was high. Our observations suggest that maternal viral suppression and breastfeeding may reduce the burden of pneumonia among HEU infants.

© 2013 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.