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Increased Risk of Serious Bacterial Infections Due to Maternal Immunosuppression in HIV-Exposed Uninfected Infants in a European Country

2014; Oxford University Press; Volume: 59; Issue: 9 Linguagem: Inglês

10.1093/cid/ciu586

1537-6591

Clément Taron-Brocard, Jérôme Le Chenadec, Albert Faye, Catherine Dollfus, Tessa Goetghebuer, Vincent Gajdos, Jean-Marc Labaune, Anaïs Perilhou, Laurent Mandelbrot, Stéphane Blanche, Josiane Warszawski, Laurent Mandelbrot, C. Crenn-Hébert, Corinne Floch-Tudal, Fabienne Mazy, Marine Joras, Françoise Meier, E. Mortier, Pierre‐François Ceccaldi, Maïa Banigé, Agnès Uludag, Virginie Zarouk, A. Lefort, Gilles Hittinger, J.-M. Chamouilli, Christian Burle, Alain Lafeuillade, M. Médus, Gastón Bachelard, Joëlle Dendale-Nguyen, Thomas Guimard, Karine Guimard, Jacques Brossier, Philippe Van de Perre, J.-L. Esnault, Olivier Bollengier Stragier, Sophie Leautez-Nainville, Sandrine Anne Martha, B. Martha, E. Maurel, M Françoise, M. Barat, Patricia Murger, Mahfoud Rouha, P Lumbroso, A Checoury, Pascale Perfezou, G Blondin, Séverine Ansart, Luc de Saint Martin, Philippe Le Moine, C Daniel, Christian Calvez, Emmanuelle Boutard, C. Arvieux, Estelle Bauville, Caroline Dupré, Yves Poinsignon, Aurore Grelier, Gaétane Mousset, Corinne Cudeville, M. Niault, Isabelle Belzic, Philippe Moreau, Marie Francoise Le Coz, O. Vaillant, Virginie Vitrat, D. Tardif, J. Gaillat, Anne Vanderbergh, Suzanne Braig, M. Dehlinger-Paul, Kamal A. Mohamed, Brigitte Heller-Roussin, Cécile Winter, Ghislaine Firtion, E. Pannier, Maria Laura Costa, Odile Launay, Dominique Salmon Ceron, Sophie Matheron, M. Rajguru, Neila Elaoun, Lahcene Allal, Élie Azria, Agnès Bourgeois Moine, Valérie Garrait, Isabelle Hau, Cyril Touboul, Lanto Ratsimbazafy, Christiane Kommé, Brigitte Elharrar, Jean-Marc Labaune, Laurent Cotte, R.-C. Rudigoz, Christophe Elleau, C. Runel-Belliard, T. Pistone, Blandine Muanza, E. Broustal, Marc Duval-Arnould, Benjamin Carpentier, Е.М. Дєньга, Marialuisa Partisani, Natacha Entz‐Werlé, Elizabeth A. David, D. Rey, H. Seaume, Sarah Ducrocq, P. Bailly-Salin, J Tricoire, A Berrébi, C. Cayla, Anne Chacé, Isabelle Metheron, Anne Boutemy, Didier Armangaud, Sophie Couderc, Cédric Routier, A. Alissa, E. Questiaux, Asma Zakaria, H. Dauphin, C. Goissen, Marie Belloy, J.-L. Delassus, Marialuisa Partisani, Geneviève Chêne, J. Lang, Dominique Brault, C Allisy, Marie-Gisèle Lebrette, Lise Selleret, François Hervé, Pascal Bolot, Marie-Aude Khuong-Josses, Dieudonné Ekoukou, S. Bounan, Stéphane Blanche, Delphine Lemercier, Pierre Frange, Florence Veber, A. Fisher, Michèle Granier, A. Devidas, Ruby H.N. Nguyen, A. May, Amélie Chabrol, P. Chevojon, Ziad Moussa, Claire Pluchart, C. Rouger, Roland Tubiana, Manuela Bonmarchand, Luminata Shneider, Fabienne Caby, Ruxandra-Oana Calin, Anne Coursol, V. Chambrin, Philippe Labrune, Laure Clech, I. Pauly-Ravelly, Raghad Moalim, L. Sánchez, Johnson Adekunle Adeniji, Eric Lachassine, L. Benoist, Vincent Jeantils, J. Gaudelus, Amélie Benbara, Anne Borgne, Lamis R. Karaoui, V. L. Elbert, A. Bongain, Fabrice Monpoux, Anne Deville, E. Galiba, Antoine Doumet, J.-L. Schmidt, L. Cravello, C. Hubert, Catherine Dollfus, François Hervé, M.-D. Tabone, Mary‐France Courcoux, Guy Leverger, B. Carbonne, Didier Pinquier, Brigitte Clavier, Gaëlle Pinto-Cardoso, Albert Faye, Sophie Matheron, Michael A. Levine, E. B. Marouts, Claire Borie, Christine Boissinot, de Peretti, C. R. Fourcade, C Chirouze, Cécile Hafner Mauvais, Véronique Reliquet, Cécile Brunet-Cartier, Norbert Winer, E. Vaucel, Claire Briandet, J. Brouard, A. Chalvon Demersay, Véronique Hentgen, Fathi Messaoudi, L. Bernard, Z. Maakroun, Pascale Nau, Kamila Kébaïli, Kareen Billiemaz, Ramona Abrudan, Pascale Fialaire, S. Proust, Philippe Arsac, Louis Mesnard, Ellen G. Werner, N Ciraru‐Vigneron, G Mouchnino, D Ayral, E. Vintejoux, M. Lalande, J. Reynes, Michel Segondy, Christiane De Gennes, C Clavel, Françoise Mazingue, Yamina Hammou, F. Ajana, Yves Hatchuel, Imad Nahri, Claire Genet, Sophie Ducroix-Roubert, Yves Aubrard, A. Constanty, P. Weinbreck, Emilie Piet, F. Jacquier, Christophe Michau, Hassan Safwan, A. Boutet, Mohamed Abdelhadi, Narcisse Elenga, Stéphane Blanche, S. Delmas, Catherine Dollfus, Albert Faye, Jérôme Le Chenadec, Laurent Mandelbrot, Anaïs Perilhou, C Rouzioux, Jeanne Sibiude, Jean‐Paul Teglas, Roland Tubiana, Josiane Warszawski,

COVID-19 Impact on Reproduction

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 <350 and 350–499 CD4/mm3 (adjusted hazard ratio = 1.7 [1.2–2.6] and 1.2 [0.8–1.9], respectively; P = .03). This association mainly concerned infections involving encapsulated bacteria (P = .03). The risk of serious viral infection was, by contrast, independent of the mother's CD4 cell count. Conclusions. Maternal CD4 count is significantly and specifically associated with the risk of serious infections with encapsulated bacteria in HEU infants.