BACKGROUND: HIV-exposed newborns may be at higher risk of sepsis because of immune system aberrations, impaired maternal antibody transfer and altered exposure to pathogenic bacteria. METHODS: We performed a secondary analysis of a study (clinicaltrials.gov, number NCT00136370) conducted between April 2004 and October 2007 in South Africa. We used propensity score matching to evaluate the association between maternal HIV infection and (1) vaginal colonization with bacterial pathogens; (2) vertical transmission of pathogens to the newborn; and (3) sepsis within 3 days of birth (EOS) or between 4-28 days of life (LOS). RESULTS: Colonization with group B Streptococcus (17% vs 23%, P = .0002), Escherichia coli (47% vs 45%, P = .374), and Klebsiella pneumoniae (7% vs 10%, P = .008) differed modestly between HIV-infected and uninfected women, as did vertical transmission rates. Maternal HIV infection was not associated with increased risk of neonatal EOS or LOS, although culture-confirmed EOS was >3 times higher among HIV-exposed infants (P = .05). When compared with HIV-unexposed, neonates, HIV-exposed, uninfected neonates (HEU) had a lower risk of EOS (20.6 vs 33.7 per 1000 births; P = .046) and similar rate of LOS (5.8 vs 4.1; P = .563). HIV-infected newborns had a higher risk than HEU of EOS (134 vs 21.5; P < .0001) and LOS (26.8 vs 5.6; P = .042). CONCLUSIONS: Maternal HIV infection was not associated with increased risk of maternal bacterial colonization, vertical transmission, EOS, or LOS. HIV-infected neonates, however, were at increased risk of EOS and LOS.
BACKGROUND: HIV-exposed newborns may be at higher risk of sepsis because of immune system aberrations, impaired maternal antibody transfer and altered exposure to pathogenic bacteria. METHODS: We performed a secondary analysis of a study (clinicaltrials.gov, number NCT00136370) conducted between April 2004 and October 2007 in South Africa. We used propensity score matching to evaluate the association between maternal HIV infection and (1) vaginal colonization with bacterial pathogens; (2) vertical transmission of pathogens to the newborn; and (3) sepsis within 3 days of birth (EOS) or between 4-28 days of life (LOS). RESULTS: Colonization with group B Streptococcus (17% vs 23%, P = .0002), Escherichia coli (47% vs 45%, P = .374), and Klebsiella pneumoniae (7% vs 10%, P = .008) differed modestly between HIV-infected and uninfected women, as did vertical transmission rates. Maternal HIV infection was not associated with increased risk of neonatal EOS or LOS, although culture-confirmed EOS was >3 times higher among HIV-exposed infants (P = .05). When compared with HIV-unexposed, neonates, HIV-exposed, uninfected neonates (HEU) had a lower risk of EOS (20.6 vs 33.7 per 1000 births; P = .046) and similar rate of LOS (5.8 vs 4.1; P = .563). HIV-infected newborns had a higher risk than HEU of EOS (134 vs 21.5; P < .0001) and LOS (26.8 vs 5.6; P = .042). CONCLUSIONS:Maternal HIV infection was not associated with increased risk of maternal bacterial colonization, vertical transmission, EOS, or LOS. HIV-infected neonates, however, were at increased risk of EOS and LOS.
Authors: Veronica Ades; Julia Mwesigwa; Paul Natureeba; Tamara D Clark; Albert Plenty; Edwin Charlebois; Jane Achan; Moses R Kamya; Diane V Havlir; Deborah Cohan; Theodore D Ruel Journal: J Trop Pediatr Date: 2013-06-13 Impact factor: 1.165
Authors: Vanessa Quan; Jennifer R Verani; Cheryl Cohen; Anne von Gottberg; Susan Meiring; Clare L Cutland; Stephanie J Schrag; Shabir A Madhi Journal: PLoS One Date: 2016-04-07 Impact factor: 3.240
Authors: Anna C Seale; Angela C Koech; Anna E Sheppard; Hellen C Barsosio; Joyce Langat; Emily Anyango; Stella Mwakio; Salim Mwarumba; Susan C Morpeth; Kirimi Anampiu; Alison Vaughan; Adam Giess; Polycarp Mogeni; Leahbell Walusuna; Hope Mwangudzah; Doris Mwanzui; Mariam Salim; Bryn Kemp; Caroline Jones; Neema Mturi; Benjamin Tsofa; Edward Mumbo; David Mulewa; Victor Bandika; Musimbi Soita; Maureen Owiti; Norris Onzere; A Sarah Walker; Stephanie J Schrag; Stephen H Kennedy; Greg Fegan; Derrick W Crook; James A Berkley Journal: Nat Microbiol Date: 2016-05-23 Impact factor: 17.745
Authors: Anna C Seale; Hannah Blencowe; Alexander A Manu; Harish Nair; Rajiv Bahl; Shamim A Qazi; Anita K Zaidi; James A Berkley; Simon N Cousens; Joy E Lawn Journal: Lancet Infect Dis Date: 2014-06-25 Impact factor: 25.071