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- Title
Adverse Health Outcomes in HIV Exposed Uninfected Children (HEU) in British Columbia.
- Authors
Chaworth-Musters, Tessa; Fernandes, Elaine; Alimenti, Ariane; Maan, Evelyn; Cote, Helene; Money, Deborah; Forbes, John
- Abstract
Background: Researchers in Europe /Africa have reported increased rates of severe infections in HEUs, prompting questions about underlying risk factors in this population. Little has been reported on the accessibility and health of HEUs in Canada. Objective: To assess the rate of adverse health outcomes in a pilot population of HEUs in BC. Methods: The pilot study was conducted at Oak Tree Clinic, the tertiary referral centre for HIV+ pregnant women and children in BC. Families were offered participation in-person or by mail with follow up phone call. Interviews included living situation, school experiences and health outcomes. Demographic, pregnancy, neonatal, and hospital visit data were extracted from clinical charts. Results: 103 HEUs were enrolled from 7/09-3/10. Participants, mean age 5.4 (0.6-19.6) years, were ethnically diverse (45.6% caucasian, 21.3% aboriginal, 19.4% black). 36.9% had prenatal exposure to drugs/alcohol, with 10% experiencing neonatal abstinence syndrome requiring therapy. 92% had in utero exposure to ARVs for a mean of 21.5 (2-41) weeks. 23.3% were born premature. 14.6% had ever lived in foster care, and 16.5% required a classroom aide. 21 HEUs (20%) reported outcomes that were of a serious nature or required hospital admission. Severe infant infections in 11 children (10.7%) included meningococcal meningitis and severe RSV infection. Five children have severe developmental problems (autism, oppositional defiant disorder). Other problems included seizure disorder, complications of prematurity, renal cell carcinoma, congenital heart disease and idiopathic arthritis. Discussion: This vulnerable cohort of HEU children reported high proportion of health problems requiring hospitalization, with infections being the most common. Factors that make this cohort vulnerable include prematurity, narcotic exposure, need for foster care, development and behaviour problems. Enrollment bias is towards families accessing care and morbidities may be underrepresented. These indicators inform the need for more comprehensive study of the entire cohort through provincial population data.
- Subjects
BRITISH Columbia; THERAPEUTIC complications; AIDS in pregnancy; VERTICAL transmission (Communicable diseases); JUVENILE diseases
- Publication
UBC Medical Journal, 2011, Vol 2, Issue 2, p12
- ISSN
1920-7425
- Publication type
Abstract