Risk of hospitalization or death does not differ in children exposed to HIV, yet uninfected compared to nonexposed

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Updated: May 28, 2025

Isolation of Leukocytes from Human Breast Milk for Use in an Antibody-dependent Cellular Phagocytosis Assay of HIV Targets
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Isolation of Leukocytes from Human Breast Milk for Use in an Antibody-dependent Cellular Phagocytosis Assay of HIV Targets

Published on: September 6, 2019

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Julie M Herlihy1,2, Ethan Zulu3, Lawrence Mwananyanda3

  • 1Boston University, Chobanian & Avedisian School of Medicine, Department of Pediatrics, Boston Medical Center.

AIDS (London, England)
|February 13, 2025
PubMed

Insights

Children exposed to HIV but uninfected (CHEU) showed no increased mortality or hospitalizations. Early combination antiretroviral therapy (cART) and exclusive breastfeeding effectively reduced morbidity in CHEU.

Area of Science:

  • Pediatric Infectious Diseases
  • Maternal and Child Health
  • Public Health Epidemiology

Background:

  • Children exposed to HIV but uninfected (CHEU) historically exhibit increased morbidity and mortality.
  • The impact of universal combination antiretroviral therapy (cART) for pregnant women and exclusive breastfeeding on CHEU health disparities remains unclear.

Purpose of the Study:

  • To assess the morbidity and mortality rates in CHEU during the first six months of life.
  • To determine if disparities in CHEU health outcomes are linked to cART initiation timing or maternal immune activation.

Main Methods:

  • A longitudinal cohort study (Zambia Infant Cohort Study) enrolled pregnant women with and without HIV (1:1 ratio).
  • Infants were monitored from birth up to 24 weeks for illnesses, hospitalizations, feeding practices, immunizations, and medication compliance.
  • Maternal health and cART status were assessed during pregnancy.

Main Results:

  • Out of 1276 livebirths, 36 deaths and 89 hospitalizations occurred within six months.
  • No significant difference in hospitalization or death rates was observed between CHEU and HIV-unexposed children (IRR 1.27, P=0.33).
  • Exclusive breastfeeding was associated with a 43% reduction in hospitalization risk.

Conclusions:

  • In a setting with moderate cART uptake, CHEU did not experience increased hospitalizations or deaths.
  • Early cART initiation and exclusive breastfeeding are effective strategies to mitigate morbidity among CHEU.
Abstract

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