Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood.
The Journal of pediatrics
Adult, Anti-HIV Agents, Breast Feeding, Child, Preschool, Diarrhea, Female, Follow-Up Studies, HIV Infections, Humans, Infant, Infant, Newborn, Infectious Disease Transmission, Vertical, Male, Pregnancy, Pregnancy Complications, Infectious, Prenatal Exposure Delayed Effects, Prospective Studies, Protective Factors, Risk Factors, Tanzania, Treatment Outcome
OBJECTIVES: To identify risk factors, including maternal antiretroviral therapy (ART), for diarrhea in Tanzanian children exposed to HIV during the first 2 years of life.
STUDY DESIGN: Using generalized estimating equations, we analyzed data from a cohort of 2387 Tanzanian children exposed to HIV from age 6 weeks to 2 years, as well as data from their mothers, to determine risk factors for diarrhea in children. Mothers recorded diarrhea in a diary and reported results at visits scheduled every four weeks.
RESULTS: Body mass index was ≥18.5 in 95.6% of mothers. World Health Organization HIV stage was 1/2 for 1255 (87.8%) mothers. ART was received by 24.3% of mothers, most initiating ART during pregnancy. At baseline (6 weeks of age) 264 (11.3%) children were infected with HIV. In children whose mothers received ART, the relative risk of diarrhea in children was 0.79 (95% CI 0.68-0.92), after we adjusted for multiple factors, including child HIV status and exclusive breastfeeding duration. Exclusive breastfeeding (relative risk 0.67, 95% CI 0.56-0.80) also was protective.
CONCLUSION: Our results provide additional support to increase ART coverage for all pregnant mothers, to control clinical HIV progression, reduce perinatal HIV infection, but also to reduce the risk of a major cause of death and morbidity in young children worldwide.
TRIAL REGISTRATION: ClinicalTrials.gov: NCT00197730.
Sztam, Kevin A; Liu, Enju; Manji, Karim P; Kupka, Roland; Kisenge, Rodrick; Aboud, Said; Fawzi, Wafaie W; Bosch, Ronald J; and Duggan, Christopher P, "Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood." (2016). Maine Medical Center. 1989.