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J Trop Pediatr. 2014 Dec;60(6):434-41. doi: 10.1093/tropej/fmu045. Epub 2014 Aug 21.

Increased morbidity in early childhood among HIV-exposed uninfected children in Uganda is associated with breastfeeding duration.

Author information

1
Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA carina.marquez@ucsf.edu.
2
Infectious Diseases Research Collaboration, Kampala, Uganda.
3
Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA.
4
Division of Infectious Diseases, Department of Pediatrics, University of California, San Francisco, CA 94143, USA.
5
Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda.
6
Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
7
Center for AIDS Prevention, University of California, San Francisco, CA 94105, USA.
8
Division of Infectious Diseases, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA.

Abstract

Human immunodeficiency virus (HIV)-exposed uninfected children (HEU) have an increased risk of morbidity and mortality compared with HIV-unexposed uninfected children (HUU); however, prior studies have not fully accounted for the role of both breastfeeding and age on this association. In this cohort of HEU and HUU in Uganda, non-breastfeeding HEU, from 6-11 months compared with non-breastfeeding HUU had a higher risk of hospitalizations [relative risk (RR): 10.1, 95% confidence interval (CI): 3.70-27.6], severe febrile illness (RR: 3.84, 95% CI: 2.06-7.17), severe diarrhea (RR: 6.37, 95% CI: 2.32-17.4) and severe malnutrition (RR: 18.4, 95% CI: 4.68-72.0). There were no differences between morbidity outcomes between breastfeeding HEU and HUU children, aged 6-11 months. In the 12-24 month age group, the only difference in morbidity outcomes among non-breast feeding children was an increased risk of severe malnutrition for HEU. These data suggest that the increased risk of morbidity among HEU aged 6-11 years is partially explained by early cessation of breastfeeding.

KEYWORDS:

Africa; Breastfeeding; HIV; HIV-exposed; Morbidity; Mortality

PMID:
25145704
PMCID:
PMC4303769
DOI:
10.1093/tropej/fmu045
[Indexed for MEDLINE]
Free PMC Article

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