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The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants
Introduction: HIV exposed but uninfected infants have been shown to have a higher morbidity and mortality than unexposed infants. There is almost no literature comparing the short-term outcomes of HIV exposed versus unexposed VLBW neonates who are born prematurely. Methods: A retrospective review of...
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| Format: | Thesis |
| Language: | English |
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Division of Neonatology
2018
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| _version_ | 1867613253235900416 |
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| access_status_str | Open Access |
| author | Riemer, Linda Jane |
| author2 | Tooke, Lloyd |
| author_browse | Riemer, Linda Jane Tooke, Lloyd |
| author_facet | Tooke, Lloyd Riemer, Linda Jane |
| author_sort | Riemer, Linda Jane |
| collection | Thesis |
| description | Introduction: HIV exposed but uninfected infants have been shown to have a higher morbidity and mortality than unexposed infants. There is almost no literature comparing the short-term outcomes of HIV exposed versus unexposed VLBW neonates who are born prematurely. Methods: A retrospective review of all VLBW neonates who were admitted at Groote Schuur Hospital nursery from 2012-2014. Data were obtained from the Vermont Oxford Database and the Prevention of Mother to Child register. Results: A total of 1593 VLBW neonates were admitted during the 3 years of which it was possible to obtain maternal HIV status in 1579 babies. Of these 1579 babies, 316 (20%)were HIV exposed. Eleven of the 230 (4.8%)infant HIV tests were positive. There was no difference in mortality, birth weight, gestational age, length of stay, sepsis and delivery room outcomes for the HIV-exposed (HIVE), maternal ARV-exposed (mARVE) and HIV-positive neonates. Differences between HIV exposed and HIV unexposed neonates were noted in an increased risk of NEC [OR 1.83 (1.2-2.8)] and an increased need for ventilation [OR 1.35 (1.01-1.8)]. Maternal antiretroviral exposed neonates developed less NEC compared with maternal antiretroviral under-exposed neonates with a birth weight under 1000grams appearing to contribute in the development and outcome of NEC. Differences in HIV-positive neonates included more chronic lung disease [OR 5.49 (1.31-23)] and more necrotising enterocolitis [OR 4.12 (1.02-17.18)]. Conclusion: This study is the first to compare the short-term outcomes of HIV exposed and HIV unexposed very low birth weight infants and consider maternal ARV exposure. It demonstrated no difference in birth weight, gestational age, mortality or sepsis. Necrotising enterocolitis is increased in the HIV exposed neonates especially if they are under-exposed to maternal antiretrovirals. Adequate maternal antiretrovirals may have a protective effect on incidence of necrotising enterocolitis and respiratory outcomes. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/27397 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:12.104Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2018 |
| publishDateRange | 2018 |
| publishDateSort | 2018 |
| publisher | Division of Neonatology |
| publisherStr | Division of Neonatology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/27397 The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants Riemer, Linda Jane Tooke, Lloyd Paediatrics Neonatology Introduction: HIV exposed but uninfected infants have been shown to have a higher morbidity and mortality than unexposed infants. There is almost no literature comparing the short-term outcomes of HIV exposed versus unexposed VLBW neonates who are born prematurely. Methods: A retrospective review of all VLBW neonates who were admitted at Groote Schuur Hospital nursery from 2012-2014. Data were obtained from the Vermont Oxford Database and the Prevention of Mother to Child register. Results: A total of 1593 VLBW neonates were admitted during the 3 years of which it was possible to obtain maternal HIV status in 1579 babies. Of these 1579 babies, 316 (20%)were HIV exposed. Eleven of the 230 (4.8%)infant HIV tests were positive. There was no difference in mortality, birth weight, gestational age, length of stay, sepsis and delivery room outcomes for the HIV-exposed (HIVE), maternal ARV-exposed (mARVE) and HIV-positive neonates. Differences between HIV exposed and HIV unexposed neonates were noted in an increased risk of NEC [OR 1.83 (1.2-2.8)] and an increased need for ventilation [OR 1.35 (1.01-1.8)]. Maternal antiretroviral exposed neonates developed less NEC compared with maternal antiretroviral under-exposed neonates with a birth weight under 1000grams appearing to contribute in the development and outcome of NEC. Differences in HIV-positive neonates included more chronic lung disease [OR 5.49 (1.31-23)] and more necrotising enterocolitis [OR 4.12 (1.02-17.18)]. Conclusion: This study is the first to compare the short-term outcomes of HIV exposed and HIV unexposed very low birth weight infants and consider maternal ARV exposure. It demonstrated no difference in birth weight, gestational age, mortality or sepsis. Necrotising enterocolitis is increased in the HIV exposed neonates especially if they are under-exposed to maternal antiretrovirals. Adequate maternal antiretrovirals may have a protective effect on incidence of necrotising enterocolitis and respiratory outcomes. 2018-02-07T12:10:06Z 2018-02-07T12:10:06Z 2017 Master Thesis Masters MMed http://hdl.handle.net/11427/27397 eng application/pdf Division of Neonatology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Paediatrics Neonatology Riemer, Linda Jane The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| thesis_degree_str | Master's |
| title | The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| title_full | The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| title_fullStr | The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| title_full_unstemmed | The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| title_short | The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants |
| title_sort | short term outcomes of hiv exposed versus hiv unexposed very low birth weight infants |
| topic | Paediatrics Neonatology |
| url | http://hdl.handle.net/11427/27397 |
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