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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000019
Clinical Science

Impact of HIV Exposure on Health Outcomes in HIV-Negative Infants Born to HIV-Positive Mothers in Sub-Saharan Africa

Moraleda, Cinta MD*,†; de Deus, Nilsa PhD*,‡; Serna-Bolea, Celia PhD; Renom, Montse MD*,†; Quintó, Llorenç BSc, MPH; Macete, Eusebio MD, PhD*,§; Menéndez, Clara MD, PhD*,†; Naniche, Denise PhD



In the article by Moraleda et al, appearing in JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 65, No. 2, pp. 182-189 entitled “Impact of HIV Exposure on Health Outcomes in HIV-Negative Infants Born to HIV-Positive Mothers in Sub-Saharan Africa,” there is an error in the methods section. Regarding the clinical definitions of moderate wasting and moderate underweight, the definitions were reversed. The correct definitions should be reflected as follows (in bold are the changes as compared to the published text): “Moderate wasting was defined as less than -2 weight-for-length Z score, moderate stunting as less than -2 length-for-age Z score, and moderate underweight as less than -2 weight-for-age Z score.” This mistake does not have implications in the results section.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 66(2):e63, June 1, 2014.

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Background: Up to 30% of infants may be HIV-exposed noninfected (ENI) in countries with high HIV prevalence, but the impact of maternal HIV on the child's health remains unclear.

Methods: One hundred fifty-eight HIV ENI and 160 unexposed (UE) Mozambican infants were evaluated at 1, 3, 9, and 12 months postdelivery. At each visit, a questionnaire was administered, and HIV DNA polymerase chain reaction and hematologic and CD4/CD8 determinations were measured. Linear mixed models were used to evaluate differences in hematologic parameters and T-cell counts between the study groups. All outpatient visits and admissions were registered. ENI infants received cotrimoxazol prophylaxis (CTXP). Negative binomial regression models were estimated to compare incidence rates of outpatient visits and admissions.

Results: Hematocrit was lower in ENI than in UE infants at 1, 3, and 9 months of age (P = 0.024, 0.025, and 0.012, respectively). Percentage of CD4 T cells was 3% lower (95% confidence interval: 0.86 to 5.15; P = 0.006) and percentage of CD8 T cells 1.15 times higher (95% confidence interval: 1.06 to 1.25; P = 0.001) in ENI vs. UE infants. ENI infants had a lower weight-for-age Z score (P = 0.049) but reduced incidence of outpatient visits, overall (P = 0.042), diarrhea (P = 0.001), and respiratory conditions (P = 0.042).

Conclusions: ENI children were more frequently anemic, had poorer nutritional status, and alterations in some immunologic profiles compared with UE children. CTXP may explain their reduced mild morbidity. These findings may reinforce continuation of CTXP and the need to understand the consequences of maternal HIV exposure in this vulnerable group of children.

© 2014 by Lippincott Williams & Wilkins


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