Diarrheal morbidity during the first 2 years of life among HIV-infected infants

Abstract

Objective. —To determine the incidence, cause, and patterns of diarrhea during the first 2 years of life among infants infected perinatally with the human immunodeficiency virus (HIV). Design. —A cohort study in which infants were enrolled shortly after birth and followed up longitudinally using biweekly surveillance for the occurrence of diarrhea. Stool specimens collected at the onset of diarrhea were evaluated for enteropathogens. Infants who were infected with HIV were compared with uninfected infants. Subjects. —Infants born to HIV-infected women at the University of Maryland Hospital, Baltimore, were recruited at 0 to 3 months of age. This analysis included 58 infants enrolled in the cohort and followed up at least 15 months (unless death intervened) whose HIV status was established (18 HIV-infected infants and 40 HIV-uninfected infants). Measurements and Results. —The overall incidence of diarrhea in HIV-infected infants was 3.2 episodes per 12 child-months compared with 1.5 episodes per 12 child-months among HIV-uninfected infants (incidence density ratio, 2.2; P + T-lymphocyte counts by 1 year of age. Conclusions. —Both acute and persistent episodes of diarrhea are major sources of morbidity in HIV-infected infants. Moreover, persistent diarrhea is a marker for rapid progression of HIV disease. ( JAMA . 1994;271:448-452)