Related Experiment Video
Updated: Jan 6, 2026
Isolation of Leukocytes from Human Breast Milk for Use in an Antibody-dependent Cellular Phagocytosis Assay of HIV Targets
Published on: September 6, 2019
Infectious morbidity among children HIV-exposed uninfected in South Africa
Kim Anderson1, Hlengiwe P Madlala2, Dorothy C Nyemba2,3
1Centre for Integrated Data and Epidemiological Research, School of Public Health, Faculty of Health Sciences.
Insights
Children HIV-exposed uninfected (CHEU) do not have an increased risk of infectious hospitalization after their first year of life. These findings suggest infancy is a critical period for interventions, offering reassurance for longer-term health outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Global Health
- Epidemiology
Background:
- Children HIV-exposed uninfected (CHEU) exhibit higher infectious morbidity and hospitalization rates in infancy compared to children HIV-unexposed uninfected (CHUU).
- Limited data exist on the long-term infectious disease risks for CHEU beyond infancy.
Purpose of the Study:
- To investigate the risk of infectious-cause hospitalization in CHEU compared to CHUU from age 1 to under 5 years.
- To determine if the increased infectious morbidity observed in infancy persists into early childhood.
Main Methods:
- A cohort study enrolled pregnant women with and without HIV in Cape Town, South Africa.
- Children's HIV status and hospitalizations were tracked via electronic healthcare data from birth to age 5.
- Random-effects Poisson regression analyzed infectious-cause hospitalizations, adjusting for relevant covariates.
Main Results:
- Among 446 CHEU and 455 CHUU, infectious-cause hospitalizations occurred at similar rates between age 1 and 5 years (aIRR=0.71; 95% CI 0.36-1.41).
- No statistically significant difference in all-cause or infectious-cause hospitalization rates was found between CHEU and CHUU in this age group.
Conclusions:
- The elevated risk of infectious-cause hospitalization in CHEU does not extend beyond the first year of life.
- Infancy represents a crucial window for targeted health interventions for CHEU.
- Findings provide reassurance regarding the long-term infectious morbidity risks for CHEU beyond infancy.
Background:
Increased risk of infectious morbidity and hospitalization has been reported during infancy among children HIV-exposed uninfected (CHEU) compared to children HIV-unexposed uninfected (CHUU). However, data on risks beyond infancy are limited.
Methods:
We enrolled pregnant women with and without HIV from a primary healthcare facility in a lower income area in Cape Town, South Africa (2017-2018). We tracked their children's HIV test results and hospitalizations using routine electronic healthcare data. We previously reported increased rates of infectious-cause hospitalization among CHEU in the first year of life, and now extend the analysis to cover the period from age 1 to less than 5 years. Using random-effects Poisson regression, we calculated adjusted incidence rate ratios (aIRR) for infectious-cause hospitalization among CHEU vs. CHUU, clustered by infant and adjusted for child sex and vaccination status, maternal age and education, and housing type.
Results:
Among 446 CHEU and 455 CHUU, 147 admissions occurred from age 1 to less than 5 years; with 59% ( n = 87) due to infections. All-cause hospitalization occurred in 9.2% of CHEU and 10.5% of CHUU; infectious-cause hospitalization occurred in 6.5% of CHEU and 7.3% of CHUU with crude incidence rates of 2.4 per 100 child-years for both groups [IRR = 1.0; 95% confidence interval (CI) 0.6-1.6]. Adjusted analyses showed no evidence of increased hospitalization among CHEU (aIRR = 0.71; 95% CI 0.36-1.41).
Conclusion:
Elevated risk of infectious-cause hospitalization among CHEU did not persist beyond the first year of life. These findings highlight infancy as a key window for targeted interventions, while providing reassurance regarding longer term infectious morbidity risk.
Related Concept Videos
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:26Sexually Transmitted Infections
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...