The impact of HIV-1 infection on child survival in the developing world.

In this study we have used a mathematical projections model and HIV-1 seroprevalence data from samples of pregnant women to estimate infant HIV-1-infection prevalence and HIV-1-attributable mortality among children. This paper presents the results of samples from six developing country capitals and Martinique. The estimated impact of HIV-1 infection on overall infant mortality is low in regions where maternal HIV-1 seroprevalence is low and overall infant mortality is high, but substantial in locations where either maternal HIV-1 seroprevalence is high, or where maternal HIV-1 seroprevalence is moderate and overall infant mortality is low. The estimates for child (ages 1-4 years) and under-5 mortality suggest that the impact of HIV-1 infection on overall mortality in children may exceed the impact on infant mortality. The recent gains made in ensuring child survival are likely to be increasingly reversed in regions where HIV-1 infection is being transmitted in a substantial proportion of pregnancies and births.