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Lancet Infect Dis. 2016 Jun;16(6):e92-e107. doi: 10.1016/S1473-3099(16)00055-4. Epub 2016 Mar 31.

HIV-exposed, uninfected infants: new global challenges in the era of paediatric HIV elimination.

Author information

1
Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
2
Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
3
Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: a.prendergast@qmul.ac.uk.

Abstract

The number of infants infected with HIV is declining with the rise in interventions for the elimination of paediatric HIV infection, but the number of uninfected infants exposed to HIV through their HIV-infected mothers is increasing. Interest in the health outcomes of HIV-exposed, uninfected infants has grown in the past decade, with several studies suggesting that these infants have increased mortality rates, increased infectious morbidity, and impaired growth compared with HIV-unexposed infants. However, heterogeneous results might reflect the inherent challenges in studies of HIV-exposed, uninfected infants, which need large populations with appropriate, contemporaneous comparison groups and repeated HIV testing throughout the period of breastfeeding. We review the effects of HIV exposure on mortality, morbidity, and growth, discuss the immunological abnormalities identified so far, and provide an overview of interventions that could be effective in this susceptible population. As the number of infants infected with HIV declines, the health needs of HIV-exposed, uninfected infants should be prioritised further, to ensure that post-2015 Sustainable Development Goals are achieved.

PMID:
27049574
DOI:
10.1016/S1473-3099(16)00055-4
[Indexed for MEDLINE]

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