TY - JOUR
T1 - Outcome of HIV exposed infants
T2 - Experience of a regional pediatric center for HIV in North India
AU - Seth, Anju
AU - Chandra, Jagdish
AU - Gupta, Rohini
AU - Kumar, Praveen
AU - Aggarwal, Varun
AU - Dutta, Ashok
PY - 2012/2
Y1 - 2012/2
N2 - Objective To study the outcome of HIV exposed infants in terms of mortality, morbidity, nutritional status and HIV infection status. Methods Retrospective analysis of data on 162 HIV exposed infants registered at Regional Pediatric Center for HIV, Delhi and meeting the inclusion criteria, was done. Results Median age at presentation was 6 wk. 17.4% mothers were on ARTwhile 44.1% received NVP prophylaxis. 61.7% babies received NVP prophylaxis. Thirty-three percent of infants were symptomatic at presentation. Feeding strategy followed was breast-feeding in 18.7%, replacement feeding 71.6% and mixed feeding 9.7%. At presentation, 50.6% infants were wasted, 48.8% stunted and 39.4% had microcephaly. A progressive increase in proportion of children with under-nutrition, stunting and microcephaly was noted with increasing age at presentation. Of the enrolled infants, 81 (50%) were alive and under follow-up. Among these, HIV infection was excluded in 65 infants (80.2% of those alive, 40.1% of the cohort). Thirty-four (21%) infants died and 47 (29%) were lost to follow-up. HIV infection was diagnosed in 24 (14.8%, 14 definite, 10 presumed). Of these 13 were alive and on ART, while 11 died. HIV status was not ascertained for the infants lost to follow-up and 23 infants who died. Conclusions HIV infection is being under-diagnosed during pregnancy. Exposed infants have a high mortality and high prevalence of malnutrition. There is an urgent need for standardizing care of exposed infants to promote follow-up and prevent mortality by offering feeding counseling and ensuring early infection detection.
AB - Objective To study the outcome of HIV exposed infants in terms of mortality, morbidity, nutritional status and HIV infection status. Methods Retrospective analysis of data on 162 HIV exposed infants registered at Regional Pediatric Center for HIV, Delhi and meeting the inclusion criteria, was done. Results Median age at presentation was 6 wk. 17.4% mothers were on ARTwhile 44.1% received NVP prophylaxis. 61.7% babies received NVP prophylaxis. Thirty-three percent of infants were symptomatic at presentation. Feeding strategy followed was breast-feeding in 18.7%, replacement feeding 71.6% and mixed feeding 9.7%. At presentation, 50.6% infants were wasted, 48.8% stunted and 39.4% had microcephaly. A progressive increase in proportion of children with under-nutrition, stunting and microcephaly was noted with increasing age at presentation. Of the enrolled infants, 81 (50%) were alive and under follow-up. Among these, HIV infection was excluded in 65 infants (80.2% of those alive, 40.1% of the cohort). Thirty-four (21%) infants died and 47 (29%) were lost to follow-up. HIV infection was diagnosed in 24 (14.8%, 14 definite, 10 presumed). Of these 13 were alive and on ART, while 11 died. HIV status was not ascertained for the infants lost to follow-up and 23 infants who died. Conclusions HIV infection is being under-diagnosed during pregnancy. Exposed infants have a high mortality and high prevalence of malnutrition. There is an urgent need for standardizing care of exposed infants to promote follow-up and prevent mortality by offering feeding counseling and ensuring early infection detection.
KW - HIV exposed infants
KW - HIV infection
KW - Mortality
KW - Nutritional status
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=84861502745&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861502745&partnerID=8YFLogxK
U2 - 10.1007/s12098-011-0532-8
DO - 10.1007/s12098-011-0532-8
M3 - Article
C2 - 21785862
AN - SCOPUS:84861502745
SN - 0019-5456
VL - 79
SP - 188
EP - 193
JO - Indian Journal of Pediatrics
JF - Indian Journal of Pediatrics
IS - 2
ER -