title: Outcome of HIV-exposed uninfected children undergoing surgery.
abstract: BACKGROUND
  HIV-exposed uninfected (HIVe) children are a rapidly growing population that may be at an increased risk of illness compared to HIV-unexposed children (HIVn). The aim of this study was to investigate the morbidity and mortality of HIVe compared to both HIVn and HIV-infected (HIVi) children after a general surgical procedure.
  
  
  METHODS
  A prospective study of children less than 60 months of age undergoing general surgery at a paediatric referral hospital from July 2004 to July 2008 inclusive. Children underwent age-definitive HIV testing and were followed up post operatively for the development of complications, length of stay and mortality.
  
  
  RESULTS
  Three hundred and eighty children were enrolled; 4 died and 11 were lost to follow up prior to HIV testing, thus 365 children were included. Of these, 38(10.4%) were HIVe, 245(67.1%) were HIVn and 82(22.5%) were HIVi children.The overall mortality was low, with 2(5.2%) deaths in the HIVe group, 0 in the HIVn group and 6(7.3%) in the HIVi group (p = 0.0003). HIVe had a longer stay than HIVn children (3 (2-7) vs. 2 (1-4) days p = 0.02). There was no significant difference in length of stay between the HIVe and HIVi groups. HIVe children had a higher rate of complications compared to HIVn children, (9 (23.7%) vs. 14(5.7%) (RR 3.8(2.1-7) p < 0.0001) but a similar rate of complications compared to HIVi children 34 (41.5%) (RR = 0.6 (0.3-1.1) p = 0.06).
  
  
  CONCLUSIONS
  HIVe children have a higher risk of developing complications and mortality after surgery compared to HIVn children. However, the risk of complications is lower than that of HIVi children.
authors.affiliation: Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, South Africa. jonathk2@chw.edu.au
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Karpelowsky
authors.forename: Alastair J W
authors.initials: AJ
authors.lastname: Millar
authors.forename: Nelleke
authors.initials: N
authors.lastname: van der Graaf
authors.forename: Guido
authors.initials: G
authors.lastname: van Bogerijen
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
mesh_terms: D000768:Anesthesia, General; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D007902:Length of Stay; D016015:Logistic Models; D009752:Nutritional Status; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology