Figure - PMC

Skip to main content

View full-text article in PMC

. Author manuscript; available in PMC: 2021 Mar 1.

Published in final edited form as: Lancet Child Adolesc Health. 2020 Jan 10;4(3):220–231. doi: 10.1016/S2352-4642(19)30375-X

FIGURE 3. — Incidence rate ratios of infection-related hospitalization between 7 days and 3 months of age comparing HIV-exposed uninfected to HIV-unexposed children

3A. Variation by maternal HIV disease severity and gestation at ART initiation in pregnancy

Legend:

IRR, crude incidence rate ratio from Poisson regression analiysis corrected for clustering; aIRR, incidence rate ratios adjusted for access to flush toilet and running water, postpartum depression, preterm birth, season at birth, being underweight in a previous age interval, quality of breastfeeding (early initiation and Exclusivity in the first 3 months) and vaccination status Reference group includes all HU children (N=405)

HEU categories (CD4 tell count and HIV viral load category boundaries set at group median value):

“Mild” (N=84): pre-ART maternal CD4 cell count > 350 cells/mm³ AND HIV viraI load <4·0 log¹⁰ copies/mL AND ART initiated prior to 24 weeks’ gestation in pregnancy (vs HU, aIRR 1–28, 95% CI 0·27-6·05)

“Moderate” (N=320): pre-ART maternal CD4 cell court ≤ 350 cells/mm³ OR HIV viral load ≥4·0 log₁₀ copies/mL but ART initiated prior to 24 weeks’ gestation in pregnancy, OR, maternal CD4 cell count > 350 cells/mm³ OR HIV viral load <4·0 log₁₀ copies/mL but ART initiation at or after 24 weeks’ gestation in pregnancy (vs HU, aIRR 3.79, 95% CI 1·75–8.18]

“Severe: (N=44): pre-ART maternal CD cell count ≤350 AND HIV viral load ≥4·0 log₁₀ copies/mL AND ART initiation at or after 24 weeks’ gestation in pregnancy (vs HU, aIRR 5·01,95% CI 1·50–16·71)

3B: Variation by quality of breastfeeding and timelines of vaccination in the first 3 months of life

Legend:

IRR, crude incidence rate ratio from Poisson regression analysis corrected for clustering; aIRR, incidence rate ratios adjusted for access to flush toilet and running water, postpartum depression, preterm birth, season at birth and being underweight in a previous age interval; “Optimal breastfeedng” defined as initiation within 1 hour of birth and exclusive breastfeeding through 3 months of age; vaccinations considered timely if all required doses received within 2 weeks of indicated age (based on 6 and 10 weeks’ South African schedule}

Reference category includes all HU children (N=405)

HEU categories:

BF+ V+: Optimal breastfeeding and timely vaccination (N=90); vs HU, aIRR 0.86, 95% CI 0.19–4.00

BF+ V−: Optimal breastfeeding but delayed or incomplete vaccination (N=14); vs HU, aIRR 2.62, 95% CI 0.32–21.26

BF− V+: Suboptimal breastfeeding but timely vaccination (N=187); vs HU, aIRR 4.15, 95% CI 1.88–9.15

BF− V−: Suboptimal breastfeeding and delayed or incomplete vaccination (N=50); vs HU, aIRR 5.24, 95% CI 1.94–14.14

FIGURE 3. — Incidence rate ratios of infection-related hospitalization between 7 days and 3 months of age comparing HIV-exposed uninfected to HIV-unexposed children

3A. Variation by maternal HIV disease severity and gestation at ART initiation in pregnancy

Legend:

IRR, crude incidence rate ratio from Poisson regression analiysis corrected for clustering; aIRR, incidence rate ratios adjusted for access to flush toilet and running water, postpartum depression, preterm birth, season at birth, being underweight in a previous age interval, quality of breastfeeding (early initiation and Exclusivity in the first 3 months) and vaccination status Reference group includes all HU children (N=405)

HEU categories (CD4 tell count and HIV viral load category boundaries set at group median value):

“Mild” (N=84): pre-ART maternal CD4 cell count > 350 cells/mm³ AND HIV viraI load <4·0 log¹⁰ copies/mL AND ART initiated prior to 24 weeks’ gestation in pregnancy (vs HU, aIRR 1–28, 95% CI 0·27-6·05)

“Moderate” (N=320): pre-ART maternal CD4 cell court ≤ 350 cells/mm³ OR HIV viral load ≥4·0 log₁₀ copies/mL but ART initiated prior to 24 weeks’ gestation in pregnancy, OR, maternal CD4 cell count > 350 cells/mm³ OR HIV viral load <4·0 log₁₀ copies/mL but ART initiation at or after 24 weeks’ gestation in pregnancy (vs HU, aIRR 3.79, 95% CI 1·75–8.18]

“Severe: (N=44): pre-ART maternal CD cell count ≤350 AND HIV viral load ≥4·0 log₁₀ copies/mL AND ART initiation at or after 24 weeks’ gestation in pregnancy (vs HU, aIRR 5·01,95% CI 1·50–16·71)

3B: Variation by quality of breastfeeding and timelines of vaccination in the first 3 months of life

Legend:

IRR, crude incidence rate ratio from Poisson regression analysis corrected for clustering; aIRR, incidence rate ratios adjusted for access to flush toilet and running water, postpartum depression, preterm birth, season at birth and being underweight in a previous age interval; “Optimal breastfeedng” defined as initiation within 1 hour of birth and exclusive breastfeeding through 3 months of age; vaccinations considered timely if all required doses received within 2 weeks of indicated age (based on 6 and 10 weeks’ South African schedule}

Reference category includes all HU children (N=405)

HEU categories:

BF+ V+: Optimal breastfeeding and timely vaccination (N=90); vs HU, aIRR 0.86, 95% CI 0.19–4.00

BF+ V−: Optimal breastfeeding but delayed or incomplete vaccination (N=14); vs HU, aIRR 2.62, 95% CI 0.32–21.26

BF− V+: Suboptimal breastfeeding but timely vaccination (N=187); vs HU, aIRR 4.15, 95% CI 1.88–9.15

BF− V−: Suboptimal breastfeeding and delayed or incomplete vaccination (N=50); vs HU, aIRR 5.24, 95% CI 1.94–14.14