Quality of Caregiving is Positively Associated With Neurodevelopment During the First Year of Life Among HIV-Exposed Uninfected Children in Uganda

Abstract Background HIV-exposed uninfected (HEU) infants show a high rate of morbidity. We aimed to investigate on biomarkers of immune activation/microbial translocation in HEU infants, evaluating the impact that infections/malnutrition can have on biomarker levels during the first year of life. Methods Clinical data of 72 Malawian infants were recorded monthly and correlated with levels of soluble CD14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FABP), analyzed longitudinally. Results Levels of sCD14 and LBP showed a significant age-related increase. Higher levels of LBP (19.4 vs. 15.2 μg/ml) were associated with stunting, affecting 30% of the infants. The association remained statistically significant after adjusting for cytomegalovirus acquisition, malaria and respiratory infections (p = 0.031). I-FABP levels were significantly increased in infants experiencing gastrointestinal infections (1442.8 vs. 860.0 pg/ml, p = 0.018). Conclusion We provide evidence that stunting is associated with an enhanced inflammatory response to microbial products in HEU children, suggesting that malnutrition status should be taken into consideration to better understand the alteration of the immune profile of HEU infants living in poor socioeconomic settings.

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Immunologic and Virologic Factors Associated with Hospitalization in HIV-Exposed, Uninfected Infants in the United States

Clinical Infectious Diseases ◽

10.1093/cid/ciab272 ◽

2021 ◽

Author(s):

Christiana Smith ◽

Yanling Huo ◽

Kunjal Patel ◽

Kirk Fetters ◽

Shannon Hegemann ◽

...

Keyword(s):

United States ◽

Regression Models ◽

The United States ◽

Pediatric Hiv ◽

First Year ◽

Virus Family ◽

Vaccine Antigens ◽

Hiv Exposed ◽

First Year Of Life ◽

Exposed Uninfected

Abstract Background HIV-exposed, uninfected (HEU) infants experience higher rates of morbidity and mortality than HIV-unexposed uninfected (HUU) infants. Few studies have examined whether particular infections and/or immune responses are associated with hospitalization among HEU infants born in the United States. Methods We evaluated a subset of HEU infants enrolled in the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1025 and/or Pediatric HIV/AIDS Cohort Study Surveillance Monitoring for ART Toxicities studies. We determined seroconversion to 6 respiratory viruses and measured antibody concentrations to 9 vaccine antigens using quantitative ELISA or electrochemiluminesence. Multivariable modified Poisson regression models were fit to evaluate the associations of seroconversion to each respiratory virus/family and antibody concentrations to vaccine antigens with the risk of hospitalization in the first year of life. Antibody concentrations to vaccine antigens were compared between HEU infants and HUU infants from a single site using multivariable linear regression models. Results Among 556 HEU infants, seroconversion to respiratory syncytial virus (RSV) and parainfluenza were associated with hospitalization [adjusted risk ratio: 1.95 (95% CI 1.21-3.15); 2.30 (1.42-3.73), respectively]. Antibody concentrations to tetanus toxoid, pertussis, and pneumococcal vaccine antigens were higher among 525 HEU compared with 100 HUU infants. No associations were observed between antibody concentrations to any vaccine and hospitalization among HEU infants. Conclusions RSV and parainfluenza contribute to hospitalization among HEU infants in the first year of life. HEU infants demonstrate robust antibody responses to vaccine antigens; therefore, humoral immune defects likely do not explain the increased susceptibility to infection observed in this population.

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284. Antibiotic Usage in the First Year of Life in HIV-Exposed, Uninfected Infants in Malawi: Results From the Breastfeeding, Antiretrovirals and Nutrition (BAN) Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.295 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S117-S117

Author(s):

Athena Kourtis ◽

Alexander Ewing ◽

Nicole Davis ◽

Dumbani Kayira ◽

Mina Hosseinipour ◽

...

Keyword(s):

Antibiotic Usage ◽

First Year ◽

Hiv Exposed ◽

First Year Of Life ◽

Exposed Uninfected

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HIV-Exposed Uninfected Infants are at Increased Risk for Severe Infections in the First Year of Life

Journal of Tropical Pediatrics ◽

10.1093/tropej/fms019 ◽

2012 ◽

Vol 58 (6) ◽

pp. 505-508 ◽

Cited By ~ 86

Author(s):

A. Slogrove ◽

B. Reikie ◽

S. Naidoo ◽

C. De Beer ◽

K. Ho ◽

...

Keyword(s):

First Year ◽

Increased Risk ◽

Severe Infections ◽

Hiv Exposed ◽

First Year Of Life ◽

Exposed Uninfected

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Valuing Health Status in the First Year of Life: The Infant Health-Related Quality of Life Instrument

Value in Health ◽

10.1016/j.jval.2018.12.009 ◽

2019 ◽

Vol 22 (6) ◽

pp. 721-727 ◽

Cited By ~ 1

Author(s):

Ruslan Jabrayilov ◽

Karin M. Vermeulen ◽

Patrick Detzel ◽

Livia Dainelli ◽

Antoinette D.I. van Asselt ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Infant Health ◽

First Year ◽

Health Related Quality ◽

Life Instrument ◽

Related Quality ◽

Health Related ◽

First Year Of Life

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Asthma-like symptoms in the first year of life and health-related quality of life at age 12 months: the Generation R study

Quality of Life Research ◽

10.1007/s11136-011-9957-9 ◽

2011 ◽

Vol 21 (3) ◽

pp. 545-554 ◽

Cited By ~ 7

Author(s):

Ashna D. Mohangoo ◽

Harry J. de Koning ◽

Johan C. de Jongste ◽

Jeanne M. Landgraf ◽

Johannes C. van der Wouden ◽

...

Keyword(s):

Quality Of Life ◽

First Year ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

First Year Of Life

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Outcome of esophageal atresia in Germany

Diseases of the Esophagus ◽

10.1093/dote/doaa093 ◽

2020 ◽

Author(s):

A Schmedding ◽

B Wittekindt ◽

R Schloesser ◽

M Hutter ◽

U Rolle

Keyword(s):

Mortality Rate ◽

Esophageal Atresia ◽

First Year ◽

Insurance Company ◽

Associated Anomalies ◽

Clinical Registry ◽

Major Health ◽

First Year Of Life ◽

Overall Mortality

Abstract The aim of this study was to evaluate the outcome of esophageal atresia in Germany in a retrospective observational study of a large cohort. Data from the major health insurance company in Germany, which covers approximately 30% of German patients, were analyzed. All patients born and registered between 2009 and 2013 with a diagnosis of esophageal atresia at first admission to the hospital were included. Mortality was analyzed during the first year of life. We identified 287 patients with esophageal atresia, including 253 with and 34 without tracheoesophageal fistula. Associated anomalies were found in 53.7% of the patients; the most frequent were cardiac anomalies (41.8%), anomalies of the urinary tract (17.4%), and atresia of the colon, rectum, and anus (9.4%). Forty-one patients (14.3%) had a birth weight <1500 g. Seventeen patients (5.9%) died before surgery. Gastrostomy was performed during the index admission in 70 patients (25.9%). The reconstruction of the esophageal passage was performed in 247 patients (93.9%). Forty-eight percent of the patients who underwent an operation required dilatation. The mortality rate in the patients who underwent an operation was 10.4%. These results from Germany correspond to the international results that have been reported. The number of dilatations was in the middle of the range of those reported in the literature; the overall mortality rate was in the upper portion of the range of the international rates. Efforts should be made to establish a clinical registry to measure and improve the quality of care for this and other rare conditions.

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Outcome in children with brain tumours diagnosed in the first year of life: long-term complications and quality of life

Archives of Disease in Childhood ◽

10.1136/adc.2007.116202 ◽

2008 ◽

Vol 93 (7) ◽

pp. 582-589 ◽

Cited By ~ 26

Author(s):

N U Gerber ◽

D Zehnder ◽

T J Zuzak ◽

A Poretti ◽

E Boltshauser ◽

...

Keyword(s):

Quality Of Life ◽

Brain Tumours ◽

First Year ◽

First Year Of Life

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Cytomegalovirus IgG Level and Avidity in Breastfeeding Infants of HIV-Infected Mothers in Malawi

Clinical and Vaccine Immunology ◽

10.1128/cvi.00460-15 ◽

2015 ◽

Vol 22 (12) ◽

pp. 1222-1226 ◽

Cited By ~ 4

Author(s):

Athena P. Kourtis ◽

Jeffrey Wiener ◽

Tiffany S. Chang ◽

Sheila C. Dollard ◽

Minal M. Amin ◽

...

Keyword(s):

High Rate ◽

First Year ◽

High Avidity ◽

Cmv Infection ◽

Igg Antibody ◽

Random Subset ◽

Resource Limited ◽

Hiv Exposed ◽

First Year Of Life ◽

Igg Level

ABSTRACTCytomegalovirus (CMV) infection is common among infants of HIV-infected mothers in resource-limited settings. We examined the prevalence and timing of infant CMV infection during the first year of life using IgG antibody and avidity among HIV-exposed infants in Malawi and correlated the results with the presence of detectable CMV DNA in the blood. The Breastfeeding, Antiretrovirals and Nutrition (BAN) study randomized 2,369 mothers and their infants to maternal antiretrovirals, infant nevirapine, or neither for 28 weeks of breastfeeding, followed by weaning. Stored plasma specimens were tested for CMV IgG and antibody avidity from a random subset of infants who had been previously tested with blood CMV PCR and had available specimens at birth and at 24 and 48 weeks of age. Ninety-four of 127 infants (74.0%) tested at 24 weeks of age had CMV IgG of low or intermediate avidity, signifying primary CMV infections. An additional 22 infants (17.3%) had IgG of high avidity; 19 of them had CMV DNA detected in their blood, indicating infant infections. Taken together, these results show that the estimated prevalence of CMV infection at 24 weeks was 88.9%. By 48 weeks of age, 81.3% of infants had anti-CMV IgG; most of them (70.9%) had IgG of high avidity. The CMV serology and avidity testing, combined with the PCR results, confirmed a high rate of primary CMV infection by 6 months of life among breastfeeding infants of HIV-infected mothers. The CMV PCR in blood detected most, but not all, infant CMV infections.

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Effectiveness of Rotarix® vaccine in Africa in the first decade of progressive introduction, 2009-2019: systematic review and meta-analysis

Wellcome Open Research ◽

10.12688/wellcomeopenres.16174.2 ◽

2020 ◽

Vol 5 ◽

pp. 187

Author(s):

Nickson Murunga ◽

Grieven P. Otieno ◽

Marta Maia ◽

Charles N. Agoti

Keyword(s):

Meta Analysis ◽

Age Groups ◽

Developed Countries ◽

Point Estimate ◽

First Year ◽

Full Dose ◽

Newcastle Ottawa Scale ◽

Group A ◽

First Year Of Life

Background: Randomized controlled trials of licensed oral rotavirus group A (RVA) vaccines, indicated lower efficacy in developing countries compared to developed countries. We investigated the pooled effectiveness of Rotarix® in Africa in 2019, a decade since progressive introduction began in 2009. Methods: A systematic search was conducted in PubMed to identify studies that investigated the effectiveness of routine RVA vaccination in an African country between 2009 and 2019. A meta-analysis was undertaken to estimate pooled effectiveness of the full-dose versus partial-dose of Rotarix® (RV1) vaccine and in different age groups. Pooled odds ratios were estimated using random effects model and the risk of bias assessed using Newcastle-Ottawa scale. The quality of the evidence was assessed using GRADE. Results: By December 2019, 39 (72%) countries in Africa had introduced RVA vaccination, of which 34 were using RV1. Thirteen eligible studies from eight countries were included in meta-analysis for vaccine effectiveness (VE) of RVA by vaccine dosage (full or partial) and age categories. Pooled RV1 VE against RVA associated hospitalizations was 44% (95% confidence interval (CI) 28-57%) for partial dose versus 58% (95% CI 50-65%) for full dose. VE was 61% (95% CI 50-69%), 55% (95% CI 32-71%), 56% (95% CI 43-67%), and 61% (95% CI 42-73%) for children aged <12 months, 12-23 months, <24 months and 12-59 months, respectively. Conclusion: RV1 vaccine use has resulted in a significant reduction in severe diarrhoea in African children and its VE is close to the efficacy findings observed in clinical trials. RV1 VE point estimate was higher for children who received full dose than those who received partial dose, and its protection lasted beyond the first year of life.

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