Hospital admission among HIV-exposed uninfected children compared with HIV-unexposed children

TY - JOUR

T1 - Hospital admission among HIV-exposed uninfected children compared with HIV-unexposed children

AU - Moseholm, Ellen

AU - Helleberg, Marie

AU - Nordly, Sannie B

AU - Rosenfeldt, Vibeke

AU - Storgaard, Merete

AU - Pedersen, Gitte

AU - Johansen, Isik S

AU - Lunding, Suzanne

AU - Weis, Nina

AU - Katzenstein, Terese L

PY - 2016/11/13

Y1 - 2016/11/13

N2 - OBJECTIVE:: The main objective of this study was, on a national level, to investigate the risk of in-hospital admissions and use of antibiotics during the first 4 years of life among HIV-exposed uninfected (HEU) children compared with a matched control group of HIV-unexposed children.DESIGN: A nationwide register-based cohort study.METHODS: All HEU children born in Denmark from 2000 to 2012 were individually matched to five HIV-unexposed controls. Outcomes were risk of hospital admission (any, because of an infectious disease, observation/nonspecific diagnosis) and use of antibiotics during the first 4 years of life. Incidence rate ratios (IRRs) were estimated using Poisson regression analysis.RESULTS: In total, 317 HEU children and 1581 matched controls were included. HEU children had a three-fold increased risk of overall admissions {incidence rate ratio (IRR) 3.49 [95% confidence interval (CI) 2.98-4.08]}. There was no difference in risk of admission because of infectious diseases [IRR 1.11 (95% CI 0.73-1.70)] and no difference in use of antibiotics [IRR 0.88 (95% CI 0.73-1.04)]. The excess risk per 100 person-years of admission was primarily caused by an increased risk of admission because of observation/nonspecific diagnosis [excess incidence rate 22.6 (95% CI 18.2-27.0), IRR 6.06 (95% CI 4.84-7.61)].CONCLUSION: HEU children had an increased risk of overall hospital admission mainly due to an increased risk of admission because of observation/nonspecific diagnosis. There was no increased risk of admission due to infectious disease. The excess risk of admission among HEU may be related to prophylactic treatment and/or HIV testing rather than somatic disease related to HIV or exposure to antiretroviral therapy.

AB - OBJECTIVE:: The main objective of this study was, on a national level, to investigate the risk of in-hospital admissions and use of antibiotics during the first 4 years of life among HIV-exposed uninfected (HEU) children compared with a matched control group of HIV-unexposed children.DESIGN: A nationwide register-based cohort study.METHODS: All HEU children born in Denmark from 2000 to 2012 were individually matched to five HIV-unexposed controls. Outcomes were risk of hospital admission (any, because of an infectious disease, observation/nonspecific diagnosis) and use of antibiotics during the first 4 years of life. Incidence rate ratios (IRRs) were estimated using Poisson regression analysis.RESULTS: In total, 317 HEU children and 1581 matched controls were included. HEU children had a three-fold increased risk of overall admissions {incidence rate ratio (IRR) 3.49 [95% confidence interval (CI) 2.98-4.08]}. There was no difference in risk of admission because of infectious diseases [IRR 1.11 (95% CI 0.73-1.70)] and no difference in use of antibiotics [IRR 0.88 (95% CI 0.73-1.04)]. The excess risk per 100 person-years of admission was primarily caused by an increased risk of admission because of observation/nonspecific diagnosis [excess incidence rate 22.6 (95% CI 18.2-27.0), IRR 6.06 (95% CI 4.84-7.61)].CONCLUSION: HEU children had an increased risk of overall hospital admission mainly due to an increased risk of admission because of observation/nonspecific diagnosis. There was no increased risk of admission due to infectious disease. The excess risk of admission among HEU may be related to prophylactic treatment and/or HIV testing rather than somatic disease related to HIV or exposure to antiretroviral therapy.

KW - Journal Article

U2 - 10.1097/QAD.0000000000001230

DO - 10.1097/QAD.0000000000001230

M3 - Journal article

C2 - 27536980

SN - 0269-9370

VL - 30

SP - 2697

EP - 2706

JO - AIDS

JF - AIDS

IS - 17

ER -