1. Increased risk of serious bacterial infections due to maternal immunosuppression in HIV-exposed uninfected infants in a European country
- Author
-
Marie Medus, Vincent Gajdos, Laure Clech, Céline Goissen, Arnaud Chalvon Demersay, Virginie Zarouk, Louis Bernard, Pierre-François Ceccaldi, René-Charles Rudigoz, Patricia Murger, Philippe Le Moine, Catherine Chirouze, Mandovi Rajguru, Ludovic Cravello, Véronique Lefevre Elbert, Luminata Shneider, Guy Leverger, Tessa Goetghebuer, Kamila Kebaili, Eliane Galiba, Claudine Touboul, Françoise Meier, Didier Tardif, Dieudoné Ekoukou, Michèle Granier, Ahmed Zakaria, Corinne Cudeville, Laurence Benoist, Emilie Piet, Emmanuelle Vintejoux, Yves Hatchuel, Christophe Michau, Jean-Luc Schmidt, Michel Françoise, Claire Briandet, Stéphane Blanche, Philippe Bailly-Salin, Anne Vanderbergh, Jeanne Sibiude, Christiane Kommé, Benoît Martha, Camille Runel-Belliard, Claire Pluchart, Imad Nahri, Vincent Jeantils, François Hervé, Isabelle Hau, Agnès Lefort, Dominique Ayral, Delphine Peretti, Stéphanie Proust, Marie Belloy, Christine Rouzioux, Arnaud Boutet, Philippe Van de Perre, Elisabeth Broustal, Cécile Hafner Mauvais, Thierry Pistone, Marie-Dominique Tabone, Hélène Dauphin, Laurent Cotte, Clement Taron-Brocard, Jean-Marie Lang, Christine Boissinot, Antoine Doumet, André Bongain, Narcisse Elenga, Geneviève Mouchnino, Anne Boutemy, Christine Cheneau, Pascale Perfezou, Pierre Frange, Mathilde Niault, Christelle Dupre, Anne Chacé, Jean-Paul Teglas, Corinne Daniel, Sophie Matheron, Severine Ansart, Martine Levine, Fabienne Caby, Marc Duval-Arnould, Isabelle Metheron, Kareen Billiemaz, Albert Faye, Didier Armangaud, Yamina Hammou, Neila Elaoun, Anne Deville, Philippe Arsac, Lydie Sanchez, Odile Luycx Vaillant, Philippe Lumbroso, Marie-Gisèle Lebrette, Norbert Winer, Elise Maurel, Ramona Abrudan, Luc De Saint Martin, Françoise Jacquier, Christian Calvez, Fabrice Monpoux, Louis Mesnard, Marie-Aude Khuong-Josses, David Rey, Isabelle Belzic, Christine Allisy, Claire Genet, Hervé Seaume, Roland Tubiana, Jacques Reynes, Pascale Nau, Gilles Blondin, Eric Lachassine, Yves Poinsignon, Cédric Arvieux, Leila Karaoui, Anaïs Perilhou, Amélie Benbara, Marine Joras, Sophie Leautez-Nainville, Sophie Ducroix-Roubert, Raghad Moalim, Pascal Bolot, Jacques Gaillat, Olivier Bollengier Stragier, Alain Devidas, Muriel Lalande, Delphine Lemercier, Jean-Pierre Brossier, Emmanuelle Boutard, Isolde Pauly-Ravelly, Marie-Françoise Le Coz, Anne Grelier, Alain Alissa, Christiane De Gennes, Jean-Luc Delassus, Emmanuel Mortier, Faiza Ajana, Ghislaine Firtion, Alain Berrebi, Rose Nguyen, Sarah Ducrocq, Jean-Marc Chamouilli, Fabienne Mazy, Maïa Banigé, Khaled Mohamed, Natacha Entz-Werle, Jacques Brouard, Germaine Bachelard, Sandrine Delmas, Anne Constanty, Véronique Reliquet, Sophie Couderc, Florence Veber, Lahcene Allal, Catherine Crenn-Hebert, Blandine Muanza, Gaelle Pinto-Cardoso, Laurent Mandelbrot, Ama Johnson, Fabienne Messaoudi, Christian Burle, Josiane Warszawski, Bénédicte Carpentier, Dominique Brault, Suzanne Braig, Pascale Fialaire, Corinne Fourcade, Elisabeth Questiaux, Véronique Chambrin, Alain Lafeuillade, Véronique Hentgen, Yves Aubrard, Anne Borgne, Sandrine-Anne Martha, Evelyne Werner, Corinne Floch-Tudal, Agnès Bourgeois Moine, Corinne Routier, Jérôme Le Chenadec, Anne Coursol, Alain Fisher, Amélie Chabrol, Cécile Winter, Cécile Brunet-Cartier, Philippe Labrune, Claudine Cayla, Françoise Mazingue, Virginie Vitrat, Cyril Clavel, Michel Segondy, Ruxandra-Oana Calin, Lise Selleret, Pierre Weinbreck, Zaitoun Abdallah Moussa, Joël Gaudelus, Gaetane Mousset, Thomas Guimard, Agnès Villemant Uludag, Emmanuelle Pannier, Brigitte Clavier, Nicole Ciraru-Vigneron, Alain Checoury, Christophe Elleau, Manuela Bonmarchand, Catherine Dollfus, Joëlle Dendale-Nguyen, Adrien May, Pierre Chevojon, Claire Hubert, Constance Borie, Marialuisa Partisani, Elie Azria, Edouard Vaucel, Erianna Bellaton Marouts, Philippe Moreau, Jean-Luc Esnault, Mahfoud Rouha, Mary-France Courcoux, Brigitte Heller-Roussin, Gilles Hittinger, Christine Rouger, Lanto Ratsimbazafy, Jean-Marc Labaune, Mohamed Abdelhadi, Brigitte Elharrar, Joëlle Tricoire, Eric David, Hassan Safwan, Karine Guimard, Bruno Carbonne, Muriel Barat, Marion Dehlinger-Paul, Stéphane Bounan, Myriam Costa, Estelle Bauville, Didier Pinquier, Valérie Garrait, Etienne Dienga, Odile Launay, Zoha Maakroun, and Dominique Salmon Ceron
- Subjects
Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,Human immunodeficiency virus (HIV) ,HIV Infections ,Kaplan-Meier Estimate ,medicine.disease_cause ,Infant, Newborn, Diseases ,Pregnancy ,medicine ,Humans ,Pregnancy Complications, Infectious ,Retrospective Studies ,business.industry ,Proportional hazards model ,Risk of infection ,Hazard ratio ,Infant, Newborn ,Infant ,Immunosuppression ,Bacterial Infections ,medicine.disease ,Confidence interval ,Infectious Disease Transmission, Vertical ,CD4 Lymphocyte Count ,Infectious Diseases ,Immunology ,Cohort ,Female ,France ,business ,Immunosuppressive Agents - Abstract
BACKGROUND Morbidity and mortality are higher among human immunodeficiency virus (HIV) exposed but uninfected (HEU) infants than unexposed infants, particularly if the mother had a low CD4 count. We investigated the possible association between maternal immune depression during pregnancy and the risk of infection in HEU infants in the national French Perinatal Cohort (EPF). METHODS All neonates, born alive, to HIV-1-infected women enrolled in the EPF between 2002 and 2010 were included. The primary outcome was the first serious (hospitalization or death) infection during the first year of life. The main exposure variable was maternal CD4 cell count near delivery. The Kaplan-Meier method and multivariate Cox models were applied, with the different types of infections managed as competing events. RESULTS Among 7638 HEU neonates, 699 had at least 1 serious infection (of which 159 were bacterial) with a Kaplan-Meier probability of 9.3% (95% confidence interval, 8.7-10.0) at 1 year. The risk of serious bacterial infection during the first year of life significantly increased with lower maternal CD4 cell count, before and after adjustment for maternal CD4 cell count
- Published
- 2014