PMID- 36695356
OWN - NLM
STAT- MEDLINE
DCOM- 20230126
LR  - 20240302
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 37
IP  - 3
DP  - 2023 Mar 1
TI  - Hospitalization among infants who initiate antiretroviral therapy before 3 months 
      of age.
PG  - 435-445
LID - 10.1097/QAD.0000000000003422 [doi]
AB  - INTRODUCTION: Studies examining hospitalization among infants with HIV in 
      resource-limited settings, in the context of early infant diagnosis and early 
      antiretroviral therapy (ART) initiation, are limited. METHODS: We used routinely 
      collected data on infants who initiated ART aged <3 months (Western Cape 
      province, South Africa; 2013-2017) to describe hospitalization from birth until 
      12 months post-ART initiation. Record reviews were additionally performed at 
      three tertiary-level facilities. We used mixed-effects Poisson regression to 
      examine factors associated with hospitalization. RESULTS: Among 840 infants, 579 
      (69%) were hospitalized; 36% had >1 hospitalization. Median age at ART initiation 
      decreased from 57 days (interquartile range [IQR] 22-74; 2013-2015) to 19 days 
      (IQR 5-54; 2016-2017). Early neonatal hospitalization (age <7 days) occurred in 
      271 infants (32%) and represented 24% of hospitalizations (272/1131). Overall, 
      443 infants (53%) were hospitalized at age >/=7 days, including 13% with 
      hospitalizations pre-ART initiation, 15% pre and post-ART initiation and 25% 
      post-ART initiation. Excluding early neonatal hospitalizations, initiating ART at 
      older age vs. age <1 week was associated with higher hospitalization rates: 
      adjusted incidence rate ratios (95% confidence interval) were 1.86 (1.31-2.64); 
      2.31 (1.62-3.29) and 2.47 (1.76-3.46) if ART initiation age was 1-4 weeks; 
      5-8 weeks and 9-12 weeks respectively. Among infants whose hospital records were 
      reviewed, reasons for early neonatal hospitalizations mostly related to 
      prematurity or low birthweight (n = 46/60; 77%) whereas hospitalizations at age 
      >/=7 days were mostly due to infections (n = 206/243; 85%). CONCLUSIONS: Earlier 
      ART initiation is associated with lower hospitalization rates. High 
      hospitalization rates, despite initiation age <3 months, is concerning.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Anderson, Kim
AU  - Anderson K
AD  - Centre for Infectious Disease Epidemiology and Research, School of Public Health, 
      Faculty of Health Sciences.
FAU - Iyun, Victoria
AU  - Iyun V
AD  - Centre for Infectious Disease Epidemiology and Research, School of Public Health, 
      Faculty of Health Sciences.
FAU - Eley, Brian S
AU  - Eley BS
AD  - Paediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, 
      Red Cross War Memorial Children's Hospital, University of Cape Town.
FAU - Rabie, Helena
AU  - Rabie H
AD  - Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch 
      University, Stellenbosch.
FAU - Ferreira, Thalia
AU  - Ferreira T
AD  - Empilweni Services and Research Unit, Department of Paediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg.
FAU - Nuttall, James
AU  - Nuttall J
AD  - Paediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, 
      Red Cross War Memorial Children's Hospital, University of Cape Town.
FAU - Frigati, Lisa
AU  - Frigati L
AD  - Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch 
      University, Stellenbosch.
FAU - Van Dongen, Nicola
AU  - Van Dongen N
AD  - Empilweni Services and Research Unit, Department of Paediatrics and Child Health, 
      Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg.
FAU - Davies, Mary-Ann
AU  - Davies MA
AD  - Centre for Infectious Disease Epidemiology and Research, School of Public Health, 
      Faculty of Health Sciences.
AD  - Directorate of Health Impact Assessment, Western Cape Department of Health, Cape 
      Town, South Africa.
CN  - IeDEA-SA
LA  - eng
GR  - U01 AI069924/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20221110
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
CIN - AIDS. 2023 Mar 1;37(3):545-546. PMID: 36695365
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Female
MH  - Infant
MH  - Humans
MH  - *HIV Infections/epidemiology
MH  - Anti-Retroviral Agents/therapeutic use
MH  - South Africa/epidemiology
MH  - Parturition
MH  - Hospitalization
PMC - PMC9881839
MID - NIHMS1847973
EDAT- 2023/01/26 06:00
MHDA- 2023/01/27 06:00
PMCR- 2024/03/01
CRDT- 2023/01/25 06:33
PHST- 2023/01/25 06:33 [entrez]
PHST- 2023/01/26 06:00 [pubmed]
PHST- 2023/01/27 06:00 [medline]
PHST- 2024/03/01 00:00 [pmc-release]
AID - 00002030-202303010-00007 [pii]
AID - 10.1097/QAD.0000000000003422 [doi]
PST - ppublish
SO  - AIDS. 2023 Mar 1;37(3):435-445. doi: 10.1097/QAD.0000000000003422. Epub 2022 Nov 
      10.