In utero ART exposure and birth and early growth outcomes among HIV-exposed uninfected infants attending immunization services : results from National PMTCT Surveillance, South Africa

Show simple item record

dc.contributor.author Ramokolo, Vundli
dc.contributor.author Goga, Ameena Ebrahim
dc.contributor.author Lombard, Carl
dc.contributor.author Doherty, Tanya
dc.contributor.author Jackson, Debra J.
dc.contributor.author Engebretsen, Ingunn M.S.
dc.date.accessioned 2018-03-15T12:17:23Z
dc.date.available 2018-03-15T12:17:23Z
dc.date.issued 2017
dc.description We would like to thank the mothers/caregivers and infants who participated in the 2012–13 South African PMTCT Evaluation survey. en_ZA
dc.description The work was presented in part at the 6th African Nutritional Epidemiology Conference; July, 21–25, 2014; Accra, Ghana and the 9th International AIDS Conference on HIV Science; July, 23–26, 2017; Paris, France. en_ZA
dc.description.abstract BACKGROUND. Despite the recognized benefit of antiretroviral therapy (ART) for preventing and treating HIV, some studies have reported adverse birth outcomes with in utero ART exposure. We evaluated the effect of infant in utero HIV and ART exposure on preterm delivery (PTD), low birth weight (LBW), small for gestational age (SGA), and underweight for age (UFA) at 6 weeks. METHODS. We surveyed 6179 HIV-unexposed-uninfected (HUU) and 2599 HIV-exposed-uninfected (HEU) infants. HEU infants were stratified into 3 groups: ART, Zidovudine alone, and no antiretrovirals (None). The ART group was further stratified to explore pre- or postconception exposure. Multivariable logistic regression evaluated effects of HIV and ARV exposure on the outcomes. RESULTS. We found higher odds of PTD, LBW, SGA, and UFA in HEU than HUU infants. HEU in the None group (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2–3.0) or those whose mothers initiated ART preconception (AOR, 1.7; 95% CI, 1.1–2.5) had almost twice the odds of PTD than infants whose mothers started ART postconception, but no increased odds for other outcomes. CONCLUSIONS. There was an association between preconception ART and PTD. As ART access increases, pregnancy registers or similar surveillance should be in place to monitor outcomes to inform future policy. en_ZA
dc.description.department Paediatrics and Child Health en_ZA
dc.description.librarian am2018 en_ZA
dc.description.sponsorship The South African National Health Scholarship Programme and the Centers for Disease Control and Prevention. en_ZA
dc.description.uri https://academic.oup.com/ofid en_ZA
dc.identifier.citation Ramokolo, V., Goga, A.E., Lombard, C. et al. 2017, 'In utero ART exposure and birth and early growth outcomes among HIV-exposed uninfected infants attending immunization services : results from National PMTCT Surveillance, South Africa ', Open Forum Infectious Diseases, vol. 4, no. 4, pp. 1-10. en_ZA
dc.identifier.issn 2328-8957 (online)
dc.identifier.other 10.1093/ofid/ofx187
dc.identifier.uri http://hdl.handle.net/2263/64289
dc.language.iso en en_ZA
dc.publisher Oxford University Press en_ZA
dc.rights The Author(s) 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/). en_ZA
dc.subject Birth outcome en_ZA
dc.subject Antiretroviral therapy (ART) en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Underweight for age (UFA) en_ZA
dc.subject Small for gestational age (SGA) en_ZA
dc.subject Low birth weight (LBW) en_ZA
dc.subject Preterm delivery (PTD) en_ZA
dc.subject Mother-to child transmission (MTCT) en_ZA
dc.title In utero ART exposure and birth and early growth outcomes among HIV-exposed uninfected infants attending immunization services : results from National PMTCT Surveillance, South Africa en_ZA
dc.type Article en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record