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Clement Taron-Brocard, Jerome Le Chenadec, Albert Faye, Catherine Dollfus, Tessa Goetghebuer, Vincent Gajdos, Jean-Marc Labaune, Anais Perilhou, Laurent Mandelbrot, Stephane Blanche, Josiane Warszawski, Laurent Mandelbrot, Catherine Crenn-Hebert, Corinne Floch-Tudal, Fabienne Mazy, Marine Joras, Françoise Meier, Emmanuel Mortier, Pierre-François Ceccaldi, Maïa Banige, Agnès Villemant Uludag, Virginie Zarouk, Agnès Lefort, Gilles Hittinger, Jean-Marc Chamouilli, Christian Burle, Alain Lafeuillade, Marie Medus, Germaine Bachelard, Joëlle Dendale-Nguyen, Thomas Guimard, Karine Guimard, Jean-Pierre Brossier, Philippe Perré, Jean-Luc Esnault, Olivier Bollengier Stragier, Sophie Leautez-Nainville, Sandrine-Anne Martha, Benoît Martha, Elise Maurel, Michel Françoise, Muriel Barat, Patricia Murger, Mahfoud Rouha, Philippe Lumbroso, Alain Checoury, Pascale Perfezou, Gilles Blondin, Séverine Ansart, Luc De Saint Martin, Philippe Le Moine, Corinne Daniel, Christian Calvez, Emmanuelle Boutard, Cédric Arvieux, Estelle Bauville, Christelle Dupre, Yves Poinsignon, Anne Grelier, Gaetane Mousset, Corinne Cudeville, Mathilde Niault, Isabelle Belzic, Philippe Moreau, Marie-Françoise Le Coz, Odile Luycx Vaillant, Virginie Vitrat, Didier Tardif, Jacques Gaillat, Anne Vanderbergh, Suzanne Braig, Marion Dehlinger-Paul, Khaled Mohamed, Brigitte Heller-Roussin, Cécile Winter, Ghislaine Firtion, Emmanuelle Pannier, Myriam Costa, Odile Launay, Dominique Salmon Ceron, Sophie Matheron, Mandovi Rajguru, Neila Elaoun, Lahcene Allal, Elie Azria, Agnès Bourgeois Moine, Valérie Garrait, Isabelle Hau, Claudine Touboul, Lanto Ratsimbazafy, Christiane Kommé, Brigitte Elharrar, Jean-Marc Labaune, Laurent Cotte, René-Charles Rudigoz, Christophe Elleau, Camille Runel-Belliard, Thierry Pistone, Blandine Muanza, Elisabeth Broustal, Marc Duval-Arnould, Bénédicte Carpentier, Etienne Dienga, MariaLuisa Partisani, Natacha Entz-Werle, Eric David, David Rey, Hervé Seaume, Sarah Ducrocq, Philippe Bailly-Salin, Joëlle Tricoire, Alain Berrebi, Claudine Cayla, Anne Chacé, Isabelle Metheron, Anne Boutemy, Didier Armangaud, Sophie Couderc, Corinne Routier, Alain Alissa, Elisabeth Questiaux, Ahmed Zakaria, Hélène Dauphin, Céline Goissen, Marie Belloy, Jean-Luc Delassus, MariaLuisa Partisani, Christine Cheneau, Jean-Marie Lang, Dominique Brault, Christine Allisy, Marie-Gisèle Lebrette, Lise Selleret, François Hervé, Pascal Bolot, Marie-Aude Khuong-Josses, Dieudoné Ekoukou, Stéphane Bounan, Stéphane Blanche, Delphine Lemercier, Pierre Frange, Florence Veber, Alain Fisher, Michèle Granier, Alain Devidas, Rose Nguyen, Adrien May, Amélie Chabrol, Pierre Chevojon, Zaitoun Abdallah Moussa, Claire Pluchart, Christine Rouger, Roland Tubiana, Manuela Bonmarchand, Luminata Shneider, Fabienne Caby, Ruxandra-Oana Calin, Anne Coursol, Véronique Chambrin, Philippe Labrune, Laure Clech, Isolde Pauly-Ravelly, Raghad Moalim, Lydie Sanchez, Ama Johnson, Eric Lachassine, Laurence Benoist, Vincent Jeantils, Joel Gaudelus, Amélie Benbara, Anne Borgne, Leïla Karaoui, Véronique Lefevre Elbert, André Bongain, Fabrice Monpoux, Anne Deville, Eliane Galiba, Antoine Doumet, Jean-Luc Schmidt, Ludovic Cravello, Claire Hubert, Catherine Dollfus, François Hervé, Marie-Dominique Tabone, Mary-France Courcoux, Guy Leverger, Bruno Carbonne, Didier Pinquier, Brigitte Clavier, Gaelle Pinto-Cardoso, Albert Faye, Sophie Matheron, Martine Levine, Erianna Bellaton Marouts, Constance Borie, Christine Boissinot, Delphine Peretti, Corinne Fourcade, Catherine Chirouze, Cécile Hafner Mauvais, Véronique Reliquet, Cécile Brunet-Cartier, Norbert Winer, Edouard Vaucel, Claire Briandet, Jacques Brouard, Arnaud Chalvon Demersay, Véronique Hentgen, Fabienne Messaoudi, Louis Bernard, Zoha Maakroun, Pascale Nau, Kamila Kebaïli, Kareen Billiemaz, Ramona Abrudan, Pascale Fialaire, Stéphanie Proust, Philippe Arsac, Louis Mesnard, Evelyne Werner, Nicole Ciraru-Vigneron, Geneviève Mouchnino, Dominique Ayral, Emmanuelle Vintejoux, Muriel Lalande, Jacques Reynes, Michel Segondy, Christiane De Gennes, Cyril Clavel, Françoise Mazingue, Yamina Hammou, Faïza Ajana, Yves Hatchuel, Imad Nahri, Claire Genet, Sophie Ducroix-Roubert, Yves Aubrard, Anne Constanty, Pierre Weinbreck, Emilie Piet, Françoise Jacquier, Christophe Michau, Hassan Safwan, Arnaud Boutet, Mohamed Abdelhadi, Narcisse Elenga, Stéphane Blanche, Sandrine Delmas, Catherine Dollfus, Albert Faye, Jérôme Le Chenadec, Laurent Mandelbrot, Anaïs Perilhou, Christine Rouzioux, Jeanne Sibiude, Jean-Paul Teglas, Roland Tubiana, Josiane Warszawski, for the France REcherche Nord&Sud Sida-HIV Hepatites - Enquete Perinatale Francaise - CO1/CO11 Study Group, Increased Risk of Serious Bacterial Infections Due to Maternal Immunosuppression in HIV-Exposed Uninfected Infants in a European Country, Clinical Infectious Diseases, Volume 59, Issue 9, 1 November 2014, Pages 1332–1345, https://doi.org/10.1093/cid/ciu586
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Abstract
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.
