Indian journal of pediatrics · 2011
Outcome of HIV exposed infants: experience of a regional pediatric center for HIV in North India.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Seth Anju, Chandra Jagdish, Gupta Rohini, Kumar Praveen, Aggarwal Varun, Dutta Ashok
Аннотация
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 ART while 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.
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 ART while 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.