Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Hospital admission among HIV-exposed
uninfected children compared with
HIV-unexposed children
Ellen Moseholm
a
, Marie Helleberg
b
, Sannie B. Nordly
c
,
Vibeke Rosenfeldt
c
, Merete Storgaard
d
, Gitte Pedersen
e
,
Isik S. Johansen
f
, Suzanne Lunding
g
, Nina Weis
a
and Terese L. Katzenstein
b
Objective: : The main objective of this study was, on a national level, to investigate the
risk of in-hospital admissions and use of antibiotics during the first 4 years of life among
HIV-exposed uninfected (HEU) children compared with a matched control group of
HIV-unexposed children.
Design: A nationwide register-based cohort study.
Methods: All HEU children born in Denmark from 2000 to 2012 were individually
matched to five HIV-unexposed controls. Outcomes were risk of hospital admission
(any, because of an infectious disease, observation/nonspecific diagnosis) and use of
antibiotics during the first 4 years of life. Incidence rate ratios (IRRs) were estimated
using Poisson regression analysis.
Results: In total, 317 HEU children and 1581 matched controls were included. HEU
children had a three-fold increased risk of overall admissions {incidence rate ratio (IRR)
3.49 [95% confidence interval (CI) 2.98–4.08]}. There was no difference in risk of
admission because of infectious diseases [IRR 1.11 (95% CI 0.73–1.70)] and no
difference in use of antibiotics [IRR 0.88 (95% CI 0.73–1.04)]. The excess risk per
100 person-years of admission was primarily caused by an increased risk of admission
because of observation/nonspecific diagnosis [excess incidence rate 22.6 (95% CI
18.2–27.0), IRR 6.06 (95% CI 4.84–7.61)].
Conclusion: HEU children had an increased risk of overall hospital admission mainly
due to an increased risk of admission because of observation/nonspecific diagnosis.
There was no increased risk of admission due to infectious disease. The excess risk of
admission among HEU may be related to prophylactic treatment and/or HIV testing
rather than somatic disease related to HIV or exposure to antiretroviral therapy.
Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved.
AIDS 2016, 30:2697–2706
Keywords: admission to hospital, children, HIV-exposed uninfected, morbidity,
national cohort study
a
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre,
b
Department of Infectious Diseases, Copenhagen
University Hospital, Rigshospitalet,
c
Department of Pediatrics, Copenhagen University Hospital, Hvidovre,
d
Department of
Infectious Diseases, Aarhus University Hospital, Skejby,
e
Department of Infectious Diseases, Aalborg University Hospital,
f
Department of Infectious Diseases, Odense University Hospital, and
g
Department of Pulmonary and Infectious Diseases,
Copenhagen University Hospital, Nordsjælland, Denmark.
Correspondence to Ellen Moseholm, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Kettega ˚rd
Alle ´ 30, Department 144, 2650 Hvidovre, Denmark.
Tel: +0045 26702548; e-mail: elar0073@regionh.dk
Received: 13 April 2016; revised: 27 June 2016; accepted: 8 July 2016.
DOI:10.1097/QAD.0000000000001230
ISSN 0269-9370 Copyright Q 2016 Wolters Kluwer Health, Inc. All rights reserved.
2697