Catherine Adler (Belgium)
Hôpital Saint-Pierre Department of PediatricsPresenter of 1 Presentation
INCREASED RISK OF RSV HOSPITALIZATIONS IN INFANTS EXPOSED TO HIV IN UTERO AND UNINFECTED (ID 934)
Abstract
Background
Respiratory syncytial virus (RSV) is the most common cause of respiratory viral infections in children worldwide. The risk factors for severe RSV infections are young age, premature birth, cardiac and pulmonary diseases and immunodeficiency. Children who are HIV exposed and uninfected (CHEU) are known to be susceptible to infections in early life. The burden of RSV in this population has been demonstrated in developing countries but poorly studied in high-income countries. The aim of our study is to evaluate the incidence of hospitalizations linked to RSV in CHEU born in Belgium.
Methods
Between December 2010 and November 2013, as part at the ELIKYA study , 130 HIV-affected and 120 uninfected pregnant women were recruited at Saint-Pierre Hospital, Brussels. Their children were followed up until the age of 1 year. Levels of RSV antibodies were measured at 6 months of age to define rates of natural infections.
Results
During the first year of life, 46 hospitalizations for infections have occurred including 11 admissions for RSV infections. Despite similar rate of seroconversion for RSV at 6 months of life, the RSV hospitalizations' incidence was 8.5 times higher in CHEU compared to CHU (IR= 7.7 per 100 person-years in CHEU vs 0.9 per 100 person-years in unexposed controls). Among CHEU, initiation of maternal ARV therapy before pregnancy was a protective factor. All hospitalizations occurred before the age of 6 months of age.
Conclusions
Our study demonstrates that despite similar exposure to RSV, CHEU born in a high-income country show excess hospitalizations linked to RSV infection. Because of their vulnerability to severe RSV infection among others infections, CHEU should be closely followed up and targeted for preventative measures including immunization.