Diarrheal morbidity during the first 2 years of life among HIV-infected infants

Publisher Website
Google Scholar
Abstract
Objective.\p=m-\Todetermine the incidence, cause, and patterns of diarrhea during the first 2 years of life among infants infected perinatally with the human immuno- deficiency virus (HIV). Design.\p=m-\Acohort study in which infants were enrolled shortly after birth and followed up longitudinally using biweekly surveillance for the occurrence of diarrhea. Stool specimens collected at the onset of diarrhea were evaluated for enteropatho- gens. Infants who were infected with HIV were compared with uninfected infants. Subjects.\p=m-\Infantsborn to HIV-infected women at the University of Maryland Hospital, Baltimore, were recruited at 0 to 3 months of age. This analysis included 58 infants enrolled in the cohort and followed up at least 15 months (unless death intervened) whose HIV status was established (18 HIV-infected infants and 40 HIV-uninfected infants). Measurements and Results.\p=m-\Theoverall incidence of diarrhea in HIV-infected infants was 3.2 episodes per 12 child-months compared with 1.5 episodes per 12 child-months among HIV-uninfected infants (incidence density ratio, 2.2; P<.05). An enteropathogen was identified in stool specimens collected during 20% of di- arrheal episodes occurring in HIV-infected infants and during 25% of diarrheal epi- sodes occurring in HIV-uninfected infants. Episodes that persisted for 14 days or longer were significantly more common among HIV-infected infants. The peak in- cidence of diarrhea occurred at 0 to 5 months of age for HIV-infected infants com- pared with 6 to 11 months for HIV-uninfected infants. Early onset of diarrhea (<6 months old) in HIV-infected infants was associated with the later development of persistent episodes of diarrhea, and those with persistent episodes had more se- vere HIV infection, characterized by a significantly higher frequency of opportunis- tic infections and lower CD4+ T-lymphocyte counts by 1 year of age. Conclusions.\p=m-\Bothacute and persistent episodes of diarrhea are major sources of morbidity in HIV-infected infants. Moreover, persistent diarrhea is a marker for rapid progression of HIV disease.

This publication has 0 references indexed in Scilit: