The Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes among Human Immunodeficiency Virus-Exposed, Uninfected Infants

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Dow, Anna ; Kayira, Dumbani ; Hudgens, Michael ; Van Rie, Annelies ; King, Caroline C. ; Ellington, Sascha ; Kourtis, Athena ; Turner, Abigail Norris ; Meshnick, Steven ; Kacheche, Zebrone ; Jamieson, Denise J. ; Chasela, Charles ; van der Horst, Charles
• Description:
  Background
  
  The World Health Organization guidelines recommend cotrimoxazole prophylactic treatment (CPT) for all HIV-exposed infants from age 6 weeks to the cessation of breastfeeding and the exclusion of HIV infection. There are limited data about the effects of CPT among this population of infants. We examined the effects of CPT on adverse health outcomes among HIV-exposed infants during the first 36 weeks of life by using data from the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, a large clinical trial of antiretroviral drugs given to the mother or infant for prevention of HIV transmission during breastfeeding.
  
  Methods
  
  For the analysis, we assigned a status of CPT-exposed to infants who were participating in the study after the CPT program started. We estimated unadjusted and adjusted hazard ratios (HRs) for the effect of CPT status on time to incident malaria, severe illness or death, anemia, and weight-for-age Z score < −2.0. Participation in the study was limited to focus exclusively on HIV-exposed, uninfected infants.
  
  Results
  
  The HR for the effect of CPT on incident malaria was 0.35 (95% confidence interval [CI]: 0.21, 0.57) during the first 10 weeks of CPT exposure, and 0.93 (95% CI: 0.67, 1.29) for the remaining 20 weeks. CPT was not associated with the other outcomes examined.
  
  Conclusions
  
  CPT offered temporary protection against malaria among HIV-exposed, uninfected infants. However, CPT offered no protection against anemia, low weight for age, or the collapsed outcome of severe illness or death.
  
  
• Subjects:
  Anemia Anti-Retroviral Agents Antibiotic Prophylaxis Antimalarials Body Weight Breast Feeding Chi-Square Distribution Female HIV Infections Humans Infant Infant, Newborn Kaplan-Meier Estimate Malaria Mothers Statistics, Nonparametric Trimethoprim, Sulfamethoxazole Drug Combination

  More +
• Keywords:
  Cotrimoxazole HIV Infants Malaria
• Source:
  Pediatr Infect Dis J. 31(8):842-847
• Pubmed ID:
  22801093
• Pubmed Central ID:
  PMC3914144
• Document Type:
  Journal Article
• Funding:
  U48 DP001944/DP/NCCDPHP CDC HHSUnited States/ ; P30-AI50410/AI/NIAID NIH HHSUnited States/ ; U48-DP000059-0/DP/NCCDPHP CDC HHSUnited States/ ; U48-DP001944-01/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP000059/DP/NCCDPHP CDC HHSUnited States/ ; U48DP001944/ACL/ACL HHSUnited States/ ; 2-D43 TW01039-06/TW/FIC NIH HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/
• Volume:
  31
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e1c4433460102bebcf57acbf07565ae5060e3dcb6227ec7a55f15e4c2d660e67
• Download URL:
  https://stacks.cdc.gov/view/cdc/33658/cdc_33658_DS1.pdf
• File Type:
  [PDF - 385.94 KB ]