title: Outcome of HIV exposed infants: experience of a regional pediatric center for HIV in North India.
abstract: OBJECTIVE
  To study the outcome of HIV exposed infants in terms of mortality, morbidity, nutritional status and HIV infection status.
  
  
  METHODS
  Retrospective analysis of data on 162 HIV exposed infants registered at Regional Pediatric Center for HIV, Delhi and meeting the inclusion criteria, was done.
  
  
  RESULTS
  Median age at presentation was 6 wk. 17.4% mothers were on ART while 44.1% received NVP prophylaxis. 61.7% babies received NVP prophylaxis. Thirty-three percent of infants were symptomatic at presentation. Feeding strategy followed was breast-feeding in 18.7%, replacement feeding 71.6% and mixed feeding 9.7%. At presentation, 50.6% infants were wasted, 48.8% stunted and 39.4% had microcephaly. A progressive increase in proportion of children with under-nutrition, stunting and microcephaly was noted with increasing age at presentation. Of the enrolled infants, 81 (50%) were alive and under follow-up. Among these, HIV infection was excluded in 65 infants (80.2% of those alive, 40.1% of the cohort). Thirty-four (21%) infants died and 47 (29%) were lost to follow-up. HIV infection was diagnosed in 24 (14.8%, 14 definite, 10 presumed). Of these 13 were alive and on ART, while 11 died. HIV status was not ascertained for the infants lost to follow-up and 23 infants who died.
  
  
  CONCLUSIONS
  HIV infection is being under-diagnosed during pregnancy. Exposed infants have a high mortality and high prevalence of malnutrition. There is an urgent need for standardizing care of exposed infants to promote follow-up and prevent mortality by offering feeding counseling and ensuring early infection detection.
authors.affiliation: Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India. anjuseth.peds@gmail.com
authors.forename: Anju
authors.initials: A
authors.lastname: Seth
authors.forename: Jagdish
authors.initials: J
authors.lastname: Chandra
authors.forename: Rohini
authors.initials: R
authors.lastname: Gupta
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Varun
authors.initials: V
authors.lastname: Aggarwal
authors.forename: Ashok
authors.initials: A
authors.lastname: Dutta
mesh_terms: D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012189:Retrospective Studies