The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants

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dc.contributor.advisorTooke, Lloyden_ZA
dc.contributor.authorRiemer, Linda Janeen_ZA
dc.date.accessioned2018-02-07T12:10:06Z
dc.date.available2018-02-07T12:10:06Z
dc.date.issued2017en_ZA
dc.description.abstractIntroduction: HIV exposed but uninfected infants have been shown to have a higher morbidity and mortality than unexposed infants. There is almost no literature comparing the short-term outcomes of HIV exposed versus unexposed VLBW neonates who are born prematurely. Methods: A retrospective review of all VLBW neonates who were admitted at Groote Schuur Hospital nursery from 2012-2014. Data were obtained from the Vermont Oxford Database and the Prevention of Mother to Child register. Results: A total of 1593 VLBW neonates were admitted during the 3 years of which it was possible to obtain maternal HIV status in 1579 babies. Of these 1579 babies, 316 (20%)were HIV exposed. Eleven of the 230 (4.8%)infant HIV tests were positive. There was no difference in mortality, birth weight, gestational age, length of stay, sepsis and delivery room outcomes for the HIV-exposed (HIVE), maternal ARV-exposed (mARVE) and HIV-positive neonates. Differences between HIV exposed and HIV unexposed neonates were noted in an increased risk of NEC [OR 1.83 (1.2-2.8)] and an increased need for ventilation [OR 1.35 (1.01-1.8)]. Maternal antiretroviral exposed neonates developed less NEC compared with maternal antiretroviral under-exposed neonates with a birth weight under 1000grams appearing to contribute in the development and outcome of NEC. Differences in HIV-positive neonates included more chronic lung disease [OR 5.49 (1.31-23)] and more necrotising enterocolitis [OR 4.12 (1.02-17.18)]. Conclusion: This study is the first to compare the short-term outcomes of HIV exposed and HIV unexposed very low birth weight infants and consider maternal ARV exposure. It demonstrated no difference in birth weight, gestational age, mortality or sepsis. Necrotising enterocolitis is increased in the HIV exposed neonates especially if they are under-exposed to maternal antiretrovirals. Adequate maternal antiretrovirals may have a protective effect on incidence of necrotising enterocolitis and respiratory outcomes.en_ZA
dc.identifier.apacitationRiemer, L. J. (2017). <i>The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Neonatology. Retrieved from http://hdl.handle.net/11427/27397en_ZA
dc.identifier.chicagocitationRiemer, Linda Jane. <i>"The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Neonatology, 2017. http://hdl.handle.net/11427/27397en_ZA
dc.identifier.citationRiemer, L. 2017. The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Riemer, Linda Jane AB - Introduction: HIV exposed but uninfected infants have been shown to have a higher morbidity and mortality than unexposed infants. There is almost no literature comparing the short-term outcomes of HIV exposed versus unexposed VLBW neonates who are born prematurely. Methods: A retrospective review of all VLBW neonates who were admitted at Groote Schuur Hospital nursery from 2012-2014. Data were obtained from the Vermont Oxford Database and the Prevention of Mother to Child register. Results: A total of 1593 VLBW neonates were admitted during the 3 years of which it was possible to obtain maternal HIV status in 1579 babies. Of these 1579 babies, 316 (20%)were HIV exposed. Eleven of the 230 (4.8%)infant HIV tests were positive. There was no difference in mortality, birth weight, gestational age, length of stay, sepsis and delivery room outcomes for the HIV-exposed (HIVE), maternal ARV-exposed (mARVE) and HIV-positive neonates. Differences between HIV exposed and HIV unexposed neonates were noted in an increased risk of NEC [OR 1.83 (1.2-2.8)] and an increased need for ventilation [OR 1.35 (1.01-1.8)]. Maternal antiretroviral exposed neonates developed less NEC compared with maternal antiretroviral under-exposed neonates with a birth weight under 1000grams appearing to contribute in the development and outcome of NEC. Differences in HIV-positive neonates included more chronic lung disease [OR 5.49 (1.31-23)] and more necrotising enterocolitis [OR 4.12 (1.02-17.18)]. Conclusion: This study is the first to compare the short-term outcomes of HIV exposed and HIV unexposed very low birth weight infants and consider maternal ARV exposure. It demonstrated no difference in birth weight, gestational age, mortality or sepsis. Necrotising enterocolitis is increased in the HIV exposed neonates especially if they are under-exposed to maternal antiretrovirals. Adequate maternal antiretrovirals may have a protective effect on incidence of necrotising enterocolitis and respiratory outcomes. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants TI - The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants UR - http://hdl.handle.net/11427/27397 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27397
dc.identifier.vancouvercitationRiemer LJ. The short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infants. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Neonatology, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27397en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Neonatologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPaediatricsen_ZA
dc.subject.otherNeonatologyen_ZA
dc.titleThe short-term outcomes of HIV-exposed versus HIV-unexposed very low birth weight infantsen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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