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HIV Exposed uninfected

Olivia Falconer, Marie-Louise Newell, Christine E Jones
The success of prevention of mother to child transmission programs over the last two decades has led to an increasing number of infants who are exposed to human immunodeficiency virus (HIV), but who are not themselves infected (HIV-exposed, uninfected infants). Although the morbidity and mortality among HIV-exposed, uninfected infants is considerably lower than that among HIV-infected infants, they may remain at increased risk of infections in the first 2 years of life compared with their HIV-unexposed peers, especially in the absence of breastfeeding...
2018: Frontiers in Immunology
Sumona Chaudhury, Gloria K Mayondi, Paige L Williams, Jean Leidner, Roger Shapiro, Modiegi Diseko, Gbolahan Ajibola, Penny Holding, Vicki Tepper, Joseph Makhema, Chipo Petlo, George R Seage, Shahin Lockman, Betsy Kammerer
OBJECTIVE: Conflicting data exist regarding the impact of in utero exposure to maternal combination antiretrovirals. We compared neurodevelopmental outcomes between HIV-exposed/uninfected (HEU) children exposed in utero to 3-drug combination antiretroviral therapy (ART) versus zidovudine (ZDV) monotherapy. DESIGN: Prospective study of child neurodevelopment, nested within two cohorts of HIV-infected mothers and their children in Botswana (one observational, one interventional)...
March 15, 2018: AIDS
Kristina Adachi, Jiahong Xu, Bonnie Ank, D Heather Watts, Margaret Camarca, Lynne M Mofenson, Jose Henrique Pilotto, Esau Joao, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa M Mussi-Pinhata, Daisy Maria Machado, Mariana Ceriotto, Mariza G Morgado, Yvonne J Bryson, Valdilea G Veloso, Beatriz Grinsztejn, Mark Mirochnick, Jack Moye, Karin Nielsen-Saines
BACKGROUND: Congenital cytomegalovirus (CMV) infection (cCMV) is an important cause of hearing loss and cognitive impairment. Prior studies suggest that HIV-exposed children are at higher risk of acquiring cCMV. We assessed the presence, magnitude, and risk factors associated with cCMV among infants born to HIV-infected women, who were not receiving antiretrovirals during pregnancy. METHODS: cCMV and urinary CMV load were determined in a cohort of infants born to HIV-infected women not receiving antiretrovirals during pregnancy...
March 9, 2018: Pediatric Infectious Disease Journal
Ronnye Rutledge, Lynn Madden, Onyema Ogbuagu, Jaimie P Meyer
Women involved in the criminal justice system (WICJ) are at high risk of acquiring HIV and would benefit from HIV pre-exposure prophylaxis (PrEP) but there are no studies in this population to inform PrEP implementation programs. We conducted a cross-sectional survey of HIV-uninfected, cis-gender women on probation, parole and/or recently released from prison/jail to assess PrEP awareness, eligibility, potential barriers to uptake, and the PrEP care continuum. The 125 WICJ surveyed reported high rates of HIV risk behaviors including recent transactional sex (22...
March 11, 2018: AIDS Care
Stephanie Benson, Katherine S Elkington, Cheng-Shiun Leu, Amelia Bucek, Curtis Dolezal, Patricia Warne, Claude Mellins
As youth with perinatally acquired HIV infection age, there is a need for studies that identify predictors and correlates of sexual risk behaviors. We examined the association between psychiatric disorders and substance use disorders (SUD) with sexual risk behaviors in youth with perinatally acquired HIV infection and perinatally HIV-exposed but uninfected youth. Participants were recruited from four medical centers in New York City. The Diagnostic Interview Schedule for Children and the Adolescent Sexual Behavior Assessment were administered to assess psychiatric disorders and sexual behaviors, respectively...
February 17, 2018: Journal of the Association of Nurses in AIDS Care: JANAC
Ilana C van Rensburg, Andre G Loxton
Regulatory B cells (Bregs) have been shown to be present during several disease states. The phenotype of the cells is not completely defined and the function of these cells differ between disease. The presence of FASL expressing (killer) B cells during latent and successfully treated TB disease have been shown but whether these cells are similar to regulatory B cells remain unclear. We assessed the receptor expression of FASL/IL5 (killer B cells), CD24/CD38 (regulatory B cells) on whole peripheral blood of participants with untreated active TB and healthy controls...
January 2018: Tuberculosis
Pui-Ying Iroh Tam, Matthew O Wiens, Jerome Kabakyenga, Julius Kiwanuka, Elias Kumbakumba, Peter P Moschovis
We evaluated the association between HIV exposed-uninfected (HEU) status, malnutrition, and risk of death in Ugandan children hospitalized with pneumonia. Both HIV exposure and infection were associated with lower anthropometric indices on univariate analysis, and mid-upper arm circumference was significantly associated with overall mortality (OR 0.96) in a multivariable model. HIV infection (OR 5.0) but not HEU status was associated with overall mortality. Malnutrition may contribute to poor pneumonia outcomes among HIV-infected and HEU children requiring hospitalization...
March 2, 2018: Pediatric Infectious Disease Journal
Anicet Christel Maloupazoa Siawaya, Ofilia Mvoundza Ndjindji, Eliane Kuissi Kamgaing, Amandine Mveang-Nzoghe, Chérone Nancy Mbani Mpega, Marielle Leboueny, Roselyne Kengue Boussougou, Armel Mintsa Ndong, Paulin N Essone, Joel Fleury Djoba Siawaya
Pathogen sensing and recognition through pattern recognition receptors, and subsequent production of pro-inflammatory cytokines, is the cornerstone of the innate immune system. Despite the fact that HIV-exposed uninfected (HEU) infants are prone to serious bacterial infections, no study has focused on the functionality of their bacteria recognition system. This is the first study to investigate baseline levels of three critically important immune response molecules in this population: complement component (C)-3, toll-like receptor (TLR)-4, and C-reactive protein (CRP)...
2018: Frontiers in Immunology
Lisa M Cranmer, Heather R Draper, Anna M Mandalakas, Soyeon Kim, George McSherry, Emma Krezinski, Joan Coetzee, Charles Mitchell, Sharon Nachman, Mercia van der Linde, Mark F Cotton, Anneke C Hesseling
Young HIV-exposed children are at high risk for TB infection. We performed QuantiFERON®-TB Gold (QFT) among HIV-exposed children in South Africa at enrolment and one year follow-up. The incidence of TB infection was high for HIV+ (11 cases/100 child-years) and HIV-exposed uninfected (HEU) children (15 cases/100 child-years). QFT may identify HIV-exposed children at risk for TB disease progression.
February 16, 2018: Pediatric Infectious Disease Journal
Matthew A Budd, Kristina Calli, Lindy Samson, Jennifer Bowes, Anthony Y Y Hsieh, John C Forbes, Ari Bitnun, Joel Singer, Fatima Kakkar, Ariane Alimenti, Evelyn J Maan, M E Suzanne Lewis, Carole Gentile, Hélène C F Côté, Jason C Brophy
Long-term outcomes of perinatal exposure to maternal antiretroviral therapy in HIV-exposed uninfected (HEU) children are unknown. However, both HIV antiretroviral therapy and autism spectrum disorder (ASD) have been associated with mitochondrial alterations. Leukocyte mitochondrial DNA (mtDNA) content can serve as a marker for mitochondrial dysfunction. In this cross-sectional, nested case-control study, HEU children with ASD were matched approximately 1:3 on age, sex, and ethnicity to HEU children without ASD, HIV-unexposed uninfected (HUU) controls, and HUU children with ASD...
February 11, 2018: Viruses
NMdu Plessis, G Ntshoe, G Reubenson, R Kularatne, L Blumberg, J Thomas, T Avenant
BACKGROUND: In low and middle-income countries, including South Africa, the epidemiology of pertussis in relation to immunisation, nutritional and HIV status is poorly described. We report on risk factors in South African children hospitalised with pertussis. METHODS: We conducted a prospective, hospital-based, sentinel surveillance programme for pertussis in Gauteng Province, South Africa. Hospitalised children (≤10 years) meeting the surveillance criteria for clinically suspected pertussis were screened and enrolled...
February 1, 2018: International Journal of Infectious Diseases: IJID
Megan S McHenry, Carole I McAteer, Eren Oyungu, Brenna C McDonald, Chris B Bosma, Philani B Mpofu, Andrew R Deathe, Rachel C Vreeman
CONTEXT: HIV-infected (HIV+) children have worse neurodevelopmental outcomes compared with HIV-uninfected children. However, little is known regarding the differences in neurodevelopment between young HIV+ children, HIV-exposed but uninfected (HEU) children, and HIV-unexposed and uninfected (HUU) children. OBJECTIVE: To systematically review and meta-analyze data on neurodevelopmental performance between young HIV+, HEU, and HUU children. DATA SOURCES: We systematically searched the following electronic bibliographic databases: Ovid Medline, Embase, PsycINFO, Education Resources Information Center, and the Cochrane Database of Systematic Reviews...
January 26, 2018: Pediatrics
Jielan Li, Lei Gao, Zhi Wen, Jing Zhang, Panying Wang, Ning Tu, Hao Lei, Fuchun Lin, Xi'en Gui, Guangyao Wu
Human immunodeficiency virus (HIV) infection significantly affect neurodevelopmental and behavioral outcomes. We investigated whether alterations of gray matter organization and structural covariance networks with vertical HIV infection adolescents exist, by using the GAT toolbox. MRI data were analysed from 25 HIV vertically infected adolescents and 33 HIV-exposed-uninfected control participants. The gray matter volume (GMV) was calculated, and structural brain networks were reconstructed from gray matter co-variance...
January 19, 2018: Scientific Reports
Jasmeen S Dara, David B Hanna, Kathryn Anastos, Rodney Wright, Betsy C Herold
Background: Prevention of mother-to-child transmission of human immunodeficiency virus (HIV) with antiretroviral therapy (ART) has been highly successful. However, HIV-exposed uninfected (HIV-EU) infants might be at increased risk for low birth weight and/or preterm birth. We compared the birth weights and gestational ages of HIV-EU infants to those of HIV-unexposed control infants in Bronx, New York, an epicenter of the HIV epidemic in the United States. Methods: This study was performed with a retrospective cohort of HIV-EU infants born at Montefiore Medical Center between 2008 and 2012 and HIV-unexposed control infants...
December 30, 2017: Journal of the Pediatric Infectious Diseases Society
Mitchell E Geffner, Kunjal Patel, Denise L Jacobson, Julia Wu, Tracie L Miller, Rohan Hazra, Mariana Gerschenson, Tanvi Sharma, Margarita Silio, Jennifer Jao, Jody K Takemoto, Russell B Van Dyke, Linda A Dimeglio
OBJECTIVE: To compare prevalence of IR between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of IR in PHIV+, and evaluate glucose metabolism. DESIGN: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of IR among PHIV+ at risk for these outcomes. METHODS: The source population was adolescents from pediatric HIV clinics in the US and Puerto Rico participating in PHACS AMP, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents...
December 26, 2017: AIDS
Mabel L Rice, Jonathan S Russell, Toni Frederick, Murli Purswani, Paige L Williams, George K Siberry, Sean M Redmond, Howard J Hoffman, Tzy-Jyun Yao
BACKGROUND: Perinatally HIV-exposed but uninfected (HEU) children have elevated risk of late language emergence at age 1 year, with possible links to in utero antiretroviral (ARV) exposure. We investigated possible risks for speech impairments (SI) and language impairments (LI) in preschool monolingual HEU children in the United States. METHODS: Speech and language assessments were conducted as part of the PHACS Surveillance Monitoring of ART Toxicities (SMARTT) study at ages 3 (N= 208) and 5 (N = 429) years...
December 22, 2017: Pediatric Infectious Disease Journal
Lili Chan, Benjamin Asriel, Ellen F Eaton, Christina M Wyatt
PURPOSE OF REVIEW: The antiviral agent tenofovir is highly effective for the treatment of HIV and hepatitis B virus infections, and the older prodrug tenofovir disoproxil fumarate (TDF) is also a component of daily preexposure prophylaxis (PrEP) to reduce the risk of HIV infection in high-risk populations. Although TDF is well tolerated, the potential for kidney and bone toxicity has important implications for public health given the large number of individuals exposed to TDF worldwide...
March 2018: Current Opinion in Nephrology and Hypertension
Ayesha Sania, Emily R Smith, Karim Manji, Christopher Duggan, Honorati Masanja, Rodrick Kisenge, Gernard Msamanga, Willy Urassa, Wafaie Fawzi
OBJECTIVES: To evaluate the risk of newborn and infant mortality associated with preterm, small for gestational age (SGA), and low birth weight (LBW) stratified by maternal HIV status and the location of birth. STUDY DESIGN: We created a prospective cohort by pooling 5 individually randomized trials. We used Cox proportional hazard models to estimate the risk of mortality for SGA defined using the recently published Intergrowth standard, preterm, LBW, and gestational age and size for gestational age categories (preterm- appropriate for gestational age [AGA], term-SGA, and preterm-SGA)...
January 2018: Journal of Pediatrics
Bethany M Henrick, Xiao-Dan Yao, Laila Nasser, Ava Roozrogousheh, Kenneth L Rosenthal
The majority of infants' breastfeeding from their HIV-infected mothers do not acquire HIV-1 infection despite exposure to cell-free virus and cell-associated virus in HIV-infected breast milk. Paradoxically, exclusive breastfeeding regardless of the HIV status of the mother has led to a significant decrease in mother-to-child transmission (MTCT) compared with non-exclusive breastfeeding. Although it remains unclear how these HIV-exposed infants remain uninfected despite repeated and prolonged exposure to HIV-1, the low rate of transmission is suggestive of a multitude of protective, short-lived bioactive innate immune factors in breast milk...
2017: Frontiers in Immunology
Abhinav Ajaykumar, Hugo Soudeyns, Fatima Kakkar, Jason Brophy, Ari Bitnun, Ariane Alimenti, Arianne Y K Albert, Deborah M Money, Hélène C F Côté
Background: Maternal combination antiretroviral therapy (cART) during pregnancy could impact the health of human immunodeficiency virus (HIV)-exposed, HIV-uninfected (HEU) children, because some antiretrovirals cross the placenta and can inhibit telomerase. Our objective was to compare leukocyte telomere length (LTL) in HEU children and HIV-unexposed, HIV-uninfected (HUU) children at birth and in early life and to investigate any relationship with cART exposure. Methods: HEU and HUU children's blood LTL was compared cross-sectionally at birth, and during the first three years of life...
February 14, 2018: Journal of Infectious Diseases
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