Prediction Models for HIV Infection in Infants: Analysis of Scoring Systems on Maternal, Infants, and Mode of Delivery Risk Factors

  • Авторлар: Latupeirissa D.1, Akib A.2, Hadinegoro S.R.3, Ibrahim F.4, Aminullah A.5, Bardosono S.6, Ismoedijanto 7, Utomo B.8
  • Мекемелер:
    1. Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Fatmawati General Hospital, Division of Tropical Pediatric and Infectious Diseases
    2. Department of Child Health, Faculty of Medicine, Division of Allergy and Immunology, University of Indonesia, Division of Allergy and Immunology, Cipto Mangunkusumo Hospital
    3. Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital
    4. Department of Microbiology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital
    5. Department of Child Health, Division of Neonatology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital
    6. Department of Nutrition, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital
    7. Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Hospital
    8. Department of Community Medicine, Faculty of Medicine, University of Indonesia
  • Шығарылым: Том 22, № 5 (2024)
  • Беттер: 329-335
  • Бөлім: Medicine
  • URL: https://rjmseer.com/1570-162X/article/view/644165
  • DOI: https://doi.org/10.2174/011570162X304984240822052915
  • ID: 644165

Дәйексөз келтіру

Толық мәтін

Аннотация

Background:Diagnosis for HIV in infants is hard to determine, particularly in limited- resource areas. A delay in the diagnosis of HIV-infected infants will lead to high morbidity and mortality. The purpose of this project is to construct a model of an HIV-positive infant and develop a useful and practical scoring system to estimate the likelihood of mother-to-child transmission that can be applied in the field.

Methods:A cross-sectional study on 100 subjects through medical records of infants born to HIV-infected mothers was conducted at four hospitals and one community health center. Several models of risk prediction scores of HIV-infected infants were then made. Furthermore, the performed validation was performed on 20 subjects of infants born to mothers with HIV in three hospitals by comparing the scoring system and the result of the PCR RNA examination performed at the age of 6 weeks old.

Results:The risk of HIV-infected infants was higher in mothers who did not receive ARV through PMTCT programs (OR 33.6; 95% CI 4.0 to 282.2), pulmonary TB infection (OR 5.1; IK95% 1.6 to 16.0) and vaginal delivery (OR 9.2; IK95 2.2 to 38.0%). Two models can predict the occurrence of infected HIV infants effectively. Model 1 consists of maternal age, maternal ARVs, lung TB infection, gestational age, mode of delivery, and sex of the infants with sensitivity and specificity of 78.9% and 70.8% (AUC=0.817 [95% CI 0.709 to 0.926]) and likelihood ratio score of 4. Model 2 consists of ARVs to the mother, pulmonary TB infection, and mode of delivery with sensitivity and specificity of 73.7% and 86.1%; AUC value of 0.812 (95% CI 0.687 to 0.938) and likelihood ratio of 5. External Validation gave similar results to the Model 2 scoring system with PCR RNA.

Conclusion:The prediction score of HIV-infected infants in Model 2 can be used in newborns of HIV-positive mothers as an effective and practical risk screening tool for HIV-infected infants before the gold standard examination by PCR.

Авторлар туралы

Debbie Latupeirissa

Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Fatmawati General Hospital, Division of Tropical Pediatric and Infectious Diseases

Хат алмасуға жауапты Автор.
Email: info@benthamscience.net

Arwin Akib

Department of Child Health, Faculty of Medicine, Division of Allergy and Immunology, University of Indonesia, Division of Allergy and Immunology, Cipto Mangunkusumo Hospital

Email: info@benthamscience.net

Sri Hadinegoro

Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital

Email: info@benthamscience.net

Fera Ibrahim

Department of Microbiology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital

Email: info@benthamscience.net

Asril Aminullah

Department of Child Health, Division of Neonatology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital

Email: info@benthamscience.net

Saptawati Bardosono

Department of Nutrition, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital

Email: info@benthamscience.net

Ismoedijanto

Department of Child Health, Division of Tropical Pediatric and Infectious Diseases, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Hospital

Email: info@benthamscience.net

Budi Utomo

Department of Community Medicine, Faculty of Medicine, University of Indonesia

Email: info@benthamscience.net

Әдебиет тізімі

  1. Joint United Nations Program on HIV/AIDS. UNAIDS Report on the global AIDS epidemic 2014. Geneva: World Health Organization 2015.
  2. Joint United Nations Program on HIV/AIDS. UNAIDS Report on the global AIDS epidemic 2012. Geneva: World Health Organization 2013.
  3. Joint United Nations Program on HIV/AIDS. UNAIDS Report on the global AIDS epidemic 2010. Geneva: World Health Organization 2011.
  4. UNAIDS epiedemiological estimates. 2022. Available from:aidsinfo.unaids.org(accessed on 7-8-2024)
  5. HIV and AIDS Data Hub for Asia-Pacific. 2013. Available from:fromwww.aidsdatahub.org(accessed on 7-8-2024)
  6. HIV and AIDS Data Hub for Asia-Pacific. Evidence to Action: Indonesia review 2022. 2022.
  7. Ditjen PP. Statistik kasus HIV/AIDS di Indonesia tahun 2014. 2014.
  8. Perkembangan HIV AIDS dan Penyakit Infeksi Menular Seksual tahun 2022. Kemkes 2022.
  9. Cooper ER, Charurat M, Mofenson L, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 2002; 29(5): 484-94. doi: 10.1097/00042560-200204150-00009 PMID: 11981365
  10. Lallemant M, Jourdain G, Le Coeur S, et al. Single-dose perinatal nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med 2004; 351(3): 217-28. doi: 10.1056/NEJMoa033500 PMID: 15247338
  11. WHO recommendations on the therapy of HIV infection in infants and children 2010. Switzerland: WHO 2010.
  12. WHO recommendations on the therapy of HIV infection in infants and children 2021. Switzerland: WHO 2021.
  13. Scott GB, Hutto C, Makuch RW, et al. Survival in children with perinatally acquired human immunodeficiency virus type 1 infection. N Engl J Med 1989; 321(26): 1791-6. doi: 10.1056/NEJM198912283212604 PMID: 2594038
  14. Sherman GG, Cooper PA, Coovadia AH, et al. Polymerase chain reaction for diagnosis of human immunodeficiency virus infection in infancy in low resource settings. Pediatr Infect Dis J 2005; 24(11): 993-7. doi: 10.1097/01.inf.0000187036.73539.8d PMID: 16282936
  15. Ginsburg AS, Miller A, Wilfert CM. Diagnosis of pediatric human immunodeficiency virus infection in resource-constrained settings. Pediatr Infect Dis J 2006; 25(11): 1057-64. doi: 10.1097/01.inf.0000243157.16405.f0 PMID: 17072130
  16. Joint United Nations Program on HIV/AIDS. UNAIDS report on the global AIDS epidemic 2009. Geneva: WHO 2011.
  17. Kovacs A. HIV disease progression and antiretroviral therapy initiation in infants/children. 2004. Available from: www.medscape.com(accessed on 7-8-2024)
  18. Abrams EJ, Matheson PB, Thomas PA, et al. Neonatal predictors of infection status and early death among 332 infants at risk of HIV-1 infection monitored prospectively from birth. Pediatrics 1995; 96(3): 451-8. doi: 10.1542/peds.96.3.451 PMID: 7651777
  19. Collins IJ, Jourdain G, Hansudewechakul R, et al. Long-term survival of HIV-infected children receiving antiretroviral therapy in Thailand: a 5-year observational cohort study. Clin Infect Dis 2010; 51(12): 1449-57. doi: 10.1086/657401 PMID: 21054181
  20. Fisher GR, Boyce TG. HIV infection and AIDS. Moffet’s Pediatric Infectious Diseases, A problem-oriented approach. (4th ed.). Philadelphia: Lippincott Williams & Wilkins 2005; pp. 666-89.
  21. Shaffer N, Roongpisuthipong A, Siriwasin W, et al. Maternal virus load and perinatal human immunodeficiency virus type 1 subtype E transmission, Thailand. J Infect Dis 1999; 179(3): 590-9. doi: 10.1086/314641 PMID: 9952365
  22. Srinirund P. Getting to zero: Thailand’s experience with e-MTCT. 20th International AIDS Conference. Melbourne. 2014.
  23. Gupta A, Bhosale R, Kinikar A, et al. Maternal tuberculosis: a risk factor for mother-to-child transmission of human immunodeficiency virus. J Infect Dis 2011; 203(3): 358-62. doi: 10.1093/jinfdis/jiq064 PMID: 21208928
  24. Beasley RP, Trepo C, Stevens C, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 1977; 105(2): 94-8. doi: 10.1093/oxfordjournals.aje.a112370 PMID: 835566
  25. Gibb DM, Goodall RL, Dunn DT, et al. Mother-to-child transmission of hepatitis C virus: evidence for preventable peripartum transmission. Lancet 2000; 356(9233): 904-7. doi: 10.1016/S0140-6736(00)02681-7 PMID: 11036896
  26. Ioannidis JPA, Abrams EJ, Ammann A, et al. Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads
  27. Mayaux MJ, Blanche S, Rouzioux C, et al. Maternal factors associated with perinatal HIV-1 transmission: the French Cohort Study: 7 years of follow-up observation. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 8(2): 188-94. doi: 10.1097/00042560-199502000-00010 PMID: 7834401
  28. Torpey K, Mandala J, Kasonde P, et al. Analysis of HIV early infant diagnosis data to estimate rates of perinatal HIV transmission in Zambia. PLoS One 2012; 7(8): e42859. doi: 10.1371/journal.pone.0042859 PMID: 22912752
  29. Pedoman penerapan terapi hiv pada anak. WHO 2014.

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