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Health and survival of HIV perinatally exposed but uninfected children born to HIV-infected mothers

Health and survival of HIV perinatally exposed but uninfected children born to HIV-infected mothers Purpose of reviewThe number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality).Recent findingsSeveral studies have reported ART-associated mitochondrial toxicity and metabolic disorders with conflicting results on adverse pregnancy outcomes, underscoring the need to conduct further investigations on these questions. Studies about congenital abnormalities report no significant differences between HEU exposed to ART and HIV-unexposed (HUU) children. Updated French data showed no significant difference in cancer incidence between HEU cART-exposed children and the general paediatric population. Furthermore, HEU children exposed to maternal cART have modest but significant impairment of development and a higher risk of growth impairment. Finally, HEU have higher risks of infections (mainly low respiratory tract infections and diarrhoea) and malaria than HUU children, particularly in children not breastfed or after early weaning. Higher mortality risk from infectious disease is reported in HEU compared to HUU children.SummaryAs we move toward the elimination of mother-to-child transmission of HIV, HEU children are an emerging population whose health outcomes remain to be fully described. Future large cohorts of HEU children using careful comparison groups of HUU in the post-ART era are needed to better understand their long-term health outcomes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in HIV & AIDS Wolters Kluwer Health

Health and survival of HIV perinatally exposed but uninfected children born to HIV-infected mothers

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
1746-630X
eISSN
1746-6318
DOI
10.1097/COH.0000000000000300
pmid
27716731
Publisher site
See Article on Publisher Site

Abstract

Purpose of reviewThe number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality).Recent findingsSeveral studies have reported ART-associated mitochondrial toxicity and metabolic disorders with conflicting results on adverse pregnancy outcomes, underscoring the need to conduct further investigations on these questions. Studies about congenital abnormalities report no significant differences between HEU exposed to ART and HIV-unexposed (HUU) children. Updated French data showed no significant difference in cancer incidence between HEU cART-exposed children and the general paediatric population. Furthermore, HEU children exposed to maternal cART have modest but significant impairment of development and a higher risk of growth impairment. Finally, HEU have higher risks of infections (mainly low respiratory tract infections and diarrhoea) and malaria than HUU children, particularly in children not breastfed or after early weaning. Higher mortality risk from infectious disease is reported in HEU compared to HUU children.SummaryAs we move toward the elimination of mother-to-child transmission of HIV, HEU children are an emerging population whose health outcomes remain to be fully described. Future large cohorts of HEU children using careful comparison groups of HUU in the post-ART era are needed to better understand their long-term health outcomes.

Journal

Current Opinion in HIV & AIDS – Wolters Kluwer Health

Published: Sep 1, 2016

References

  • Global update on the health sector response to HIV 2014 [updated February 2014; cited 2015 21 June 2015]
  • Editorial commentary: new challenges in the elimination of pediatric HIV infection: the expanding population of HIV-exposed but uninfected children
  • The HIV-exposed, uninfected African child
  • Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis
  • Fetal consequences of maternal antiretroviral nucleoside reverse transcriptase inhibitor use in human and nonhuman primate pregnancy
  • Decreased mitochondrial function among healthy infants exposed to antiretrovirals during gestation, delivery and the neonatal period
  • Lower preprandial insulin and altered fuel use in HIV/antiretroviral-exposed infants in cameroon
  • Acylcarnitine profiles in HIV-exposed, uninfected neonates in the United States
  • Antiretroviral exposure during pregnancy and adverse outcomes in HIV-exposed uninfected infants and children using a trigger-based design
  • Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis
  • Safety of cotrimoxazole in pregnancy: a systematic review and meta-analysis
  • Safety of efavirenz in the first trimester of pregnancy: an updated systematic review and meta-analysis
  • Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy
  • Pregnancy outcomes and birth defects from an antiretroviral drug safety study of women in South Africa and Zambia
  • Association between in utero zidovudine exposure and nondefect adverse birth outcomes: analysis of prospectively collected data from the Antiretroviral Pregnancy Registry
  • Prenatal exposure to zidovudine and risk for ventricular septal defects and congenital heart defects: data from the Antiretroviral Pregnancy Registry
  • Congenital anomalies and in utero antiretroviral exposure in human immunodeficiency virus-exposed uninfected infants
  • In utero exposure to zidovudine and heart anomalies in the ANRS French perinatal cohort and the nested PRIMEVA randomized trial
  • Association between prenatal exposure to antiretroviral therapy and birth defects: an analysis of the French perinatal cohort study (ANRS CO1/CO11)
  • First trimester exposure to antiretroviral therapy and risk of birth defects
  • Cardiac effects of in-utero exposure to antiretroviral therapy in HIV-uninfected children born to HIV-infected mothers
  • Risk of cancer in children exposed to didanosine in utero
  • Genotoxic signature in cord blood cells of newborns exposed in utero to a Zidovudine-based antiretroviral combination
  • Comparing genotoxic signatures in cord blood cells from neonates exposed in utero to zidovudine or tenofovir
  • Safety of perinatal exposure to antiretroviral medications: developmental outcomes in infants
  • Cognitive and language outcomes in HIV-uninfected infants exposed to combined antiretroviral therapy in utero and through extended breast-feeding
  • Evaluation of risk for late language emergence after in utero antiretroviral drug exposure in HIV-exposed uninfected infants
  • Neurodevelopmental outcomes in HIV-exposed-uninfected children versus those not exposed to HIV
  • Meconium atazanavir concentrations and early language outcomes in HIV-exposed uninfected infants with prenatal atazanavir exposure
  • Growth of human immunodeficiency type 1-infected and uninfected children: a prospective cohort study in Kigali, Rwanda, 1988 to 1993
  • Patterns of postnatal growth in HIV-infected and HIV-exposed children
  • Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomized controlled trial
  • Growth and health outcomes at school age in HIV-exposed, uninfected Zambian children: follow-up of two cohorts studied in infancy
  • Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda
  • Growth and body composition of uninfected children exposed to human immunodeficiency virus: comparison with a contemporary cohort and United States National Standards
  • HIV infection, viral load, low birth weight, and nevirapine are independent influences on growth velocity in HIV-exposed South African infants
  • Effects of in utero antiretroviral exposure on longitudinal growth of HIV-exposed uninfected infants in Botswana
  • In-utero triple antiretroviral exposure associated with decreased growth among HIV-exposed uninfected infants in Botswana
  • Growth in late infancy among HIV-exposed children in urban Haiti is associated with participation in a clinic-based infant feeding support intervention
  • Lower newborn bone mineral content associated with maternal use of tenofovir disoproxil fumarate during pregnancy
  • Safety of tenofovir use during pregnancy: early growth outcomes in HIV-exposed uninfected infants
  • In utero exposure to tenofovir disoproxil fumarate does not impair growth and bone health in HIV-uninfected children born to HIV-infected mothers
  • Infant growth outcomes after maternal tenofovir disoproxil fumarate use during pregnancy
  • Premature delivery in HIV-infected women starting protease inhibitor therapy during pregnancy: role of the ritonavir boost?
  • Morbidity among human immunodeficiency virus-exposed but uninfected, human immunodeficiency virus-infected, and human immunodeficiency virus-unexposed infants in Zimbabwe before availability of highly active antiretroviral therapy
  • Mortality risk and associated factors in HIV-exposed, uninfected children
  • Mortality of HIV-infected and uninfected children in a longitudinal cohort in rural south-west Uganda during 8 years of follow-up
  • High incidence of invasive group B streptococcal infections in HIV-exposed uninfected infants
  • Treatment failures and excess mortality among hiv-exposed, uninfected children with pneumonia
  • Health outcomes of HIV-exposed uninfected African infants
  • Severe infections in HIV-exposed uninfected infants born in a European country
  • Increased risk of serious bacterial infections due to maternal immunosuppression in HIV-exposed uninfected infants in a European country
  • Increased risk for and mortality from invasive pneumococcal disease in HIV-exposed but uninfected infants aged <1 year in South Africa, 2009–2013
  • Exclusive breastfeeding, diarrhoeal morbidity and all-cause mortality in infants of HIV-infected and HIV uninfected mothers: an intervention cohort study in KwaZulu Natal, South Africa
  • Morbidity in relation to feeding mode in African HIV-exposed, uninfected infants during the first 6 mo of life: the Kesho Bora study
  • Elevations in mortality associated with weaning persist into the second year of life among uninfected children born to HIV-infected mothers
  • Increased morbidity in early childhood among HIV-exposed uninfected children in Uganda is associated with breastfeeding duration
  • Morbidity and mortality in HIV-exposed uninfected children
  • Revisiting pneumonia and exposure status in infants born to HIV-infected mothers
  • HIV-exposed uninfected infants are at increased risk for severe infections in the first year of life
  • Patterns of infectious morbidity in HIV-exposed uninfected infants and children
  • Infections in HIV-exposed uninfected children with focus on sub-Saharan Africa
  • Increased risk for group B Streptococcus sepsis in young infants exposed to HIV, Soweto, South Africa, 2004–2008(1)
  • Group B streptococcal disease in infants
  • Survival and health benefits of breastfeeding versus artificial feeding in infants of HIV-infected women: developing versus developed world
  • Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival
  • HIV-exposed uninfected children: a growing population with a vulnerable immune system?
  • Uninfected but not unaffected: chronic maternal infections during pregnancy, fetal immunity, and susceptibility to postnatal infections
  • Antibody responses to vaccination among South African HIV-exposed and unexposed uninfected infants during the first 2 years of life
  • Altered innate immune development in HIV-exposed uninfected infants