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Hospital admission among HIV-exposed uninfected children compared with HIV-unexposed children. | LitMetric

Hospital admission among HIV-exposed uninfected children compared with HIV-unexposed children.

AIDS

aDepartment of Infectious Diseases, Copenhagen University Hospital, Hvidovre bDepartment of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet cDepartment of Pediatrics, Copenhagen University Hospital, Hvidovre dDepartment of Infectious Diseases, Aarhus University Hospital, Skejby eDepartment of Infectious Diseases, Aalborg University Hospital fDepartment of Infectious Diseases, Odense University Hospital gDepartment of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Nordsjælland, Denmark.

Published: November 2016

AI Article Synopsis

  • The study aimed to assess the risk of in-hospital admissions and antibiotic use in HIV-exposed uninfected (HEU) children compared to HIV-unexposed children in Denmark.
  • It found that HEU children had a three-fold increased risk of hospital admissions overall, largely due to non-specific observations rather than infectious diseases.
  • There was no significant difference in the risk of admissions related to infectious diseases or in antibiotic usage between HEU and matched control groups.

Article Abstract

Objective: The main objective of this study was, on a national level, to investigate the risk of in-hospital admissions and use of antibiotics during the first 4 years of life among HIV-exposed uninfected (HEU) children compared with a matched control group of HIV-unexposed children.

Design: A nationwide register-based cohort study.

Methods: All HEU children born in Denmark from 2000 to 2012 were individually matched to five HIV-unexposed controls. Outcomes were risk of hospital admission (any, because of an infectious disease, observation/nonspecific diagnosis) and use of antibiotics during the first 4 years of life. Incidence rate ratios (IRRs) were estimated using Poisson regression analysis.

Results: In total, 317 HEU children and 1581 matched controls were included. HEU children had a three-fold increased risk of overall admissions {incidence rate ratio (IRR) 3.49 [95% confidence interval (CI) 2.98-4.08]}. There was no difference in risk of admission because of infectious diseases [IRR 1.11 (95% CI 0.73-1.70)] and no difference in use of antibiotics [IRR 0.88 (95% CI 0.73-1.04)]. The excess risk per 100 person-years of admission was primarily caused by an increased risk of admission because of observation/nonspecific diagnosis [excess incidence rate 22.6 (95% CI 18.2-27.0), IRR 6.06 (95% CI 4.84-7.61)].

Conclusion: HEU children had an increased risk of overall hospital admission mainly due to an increased risk of admission because of observation/nonspecific diagnosis. There was no increased risk of admission due to infectious disease. The excess risk of admission among HEU may be related to prophylactic treatment and/or HIV testing rather than somatic disease related to HIV or exposure to antiretroviral therapy.

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Source
http://dx.doi.org/10.1097/QAD.0000000000001230DOI Listing

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