Follow-up and Outcomes of Infants Perinatally-exposed to HIV in a Low-prevalence Setting: The Multicenter Children’s HIV Exposure Study 2
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To investigate the follow-up and outcomes of HIV-exposed infants in a setting of low HIV prevalence. STUDY DESIGN: This was a multicenter, retrospective study of live-born infants of women known to be living with HIV, at 9 tertiary pediatric centers in Australia and New Zealand from 2009-2025. Antenatal, perinatal, and postnatal data, and outcomes at clinic visits to 18 months of age were collected, including co-morbidities, development, and HIV results. RESULTS: Six hundred sixty-eight infants were born from 657 pregnancies to 530 women living with HIV. Two (0.3%) infants were HIV-infected. Regarding preventative interventions, 612/616 (99.4%) pregnant women received combination antiretroviral (ARV) therapy, 660/661 (99.8%) infants received ARV prophylaxis, and 543/568 (96%) exclusively formula fed. A total of 94/588 (16%) born <37 weeks, 106/600 (18%) had birth weight <2500 g, and 26/642 (4%) had congenital abnormalities. HIV polymerase chain reaction (PCR) testing was done for 621/668 (93%) within 2 weeks, 598/664 (90%) at 6 weeks, 582/657 (89%) after 3 months, with a combined total of 643/657 (98%) infants having at least one post 6-week HIV PCR result. At 18-month follow-up, 24/426 (6%) had developmental delay and 47/426 (11%) had at least 1 comorbidity. A total of 577/668 (86%) infants were confirmed as HIV-negative by either negative antibody or 2 negative PCR tests over the age of 6 weeks. CONCLUSIONS: The perinatal transmission rate of 0.3% was extremely low. While the majority of infants were followed up well, the proportion of infants with developmental delay and co-morbidities highlights the need for improved engagement, even in a low-prevalence setting.
Authors: Penelope A Bryant, Adam W Bartlett, Asha Bowen, Ellen Caukill, Tom Connell, Lee Fairhead, Timothy J Ford, Joshua R Francis, Michelle L Giles, Melanie Hilder, Paul Griffin, Ameneh Khatami, Yasser Mansour, Sarah Masterton, Claire McFaul, Brendan McMullan, Claire Mohr, Charlotte Potter, Brett Ritchie, Tom Snelling, Nan Vasilunas, Tony Walls, Pamela Palasanthiran, Kathryn Shepherd, Clare Nourse
Institutions: Royal Children's Hospital, The University of Melbourne, Murdoch Children's Research Institute, UNSW Sydney, Sydney Children's Hospital, Sydney Children’s Hospitals Network, Kirby Institute, The Kids Research Institute Australia, The University of Western Australia, Princess Margaret Hospital for Children, Perth Children's Hospital, Fiona Stanley Hospital, Charles Darwin University, Menzies School of Health Research, Royal Darwin Hospital, Royal Women's Hospital, Monash University, Children's Health Queensland Hospital and Health Service, Mater Health Services, The University of Queensland, The University of Sydney, Children's Hospital at Westmead, Westmead Hospital, Christchurch Hospital, Mater Adult Hospital, Women's and Children's Hospital, Women's and Children's Health Network, University of Otago
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,752
OpenAlex ID: W4417330529