OBJECTIVE To compare short-term outcomes of very low birthweight (VBLW, <1500 g) neonates by maternal HIV status. DESIGN Retrospective hospital-based cohort in Cape Town, South Africa. RESULTS Of 1579 mothers, 316 (20%) were HIV-positive; 183/316 (58%) received ≥8 weeks of antenatal antiretrovirals. HIV-exposed neonates (HIVE, vs HIV-unexposed, HIVU) had increased risk of necrotising enterocolitis (NEC; OR 1.93, 95% CI 1.27-2.92) and invasive ventilation (OR 1.35, 95% CI 1.01-1.79). Extremely low birthweight (ELBW, <1000 g) modified the HIV-exposure-mortality relationship: among ELBW neonates, HIVE vs HIVU mortality OR 1.75 (95% CI 1.13-2.69); among non-ELBW, OR 0.89 (95% CI 0.54-1.49). Antiretrovirals (≥8 vs <8 weeks/none) reduced NEC (OR 0.46, 95% CI 0.22-0.97) and invasive ventilation risks (OR 0.57, 95% CI 0.32-0.99). HIV-PCR results were available for 228/316 (72%) HIVE neonates; 11/228 (5%) tested positive. CONCLUSIONS Among VLBW neonates, HIV-exposure was associated with increased risk of adverse short-term outcomes; antenatal antiretrovirals were protective.

中文翻译：

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暴露于HIV和未暴露HIV的早产，极低出生体重新生儿的短期结果：一项基于医院的纵向研究。

目的根据孕产妇艾滋病毒状况比较极低出生体重（VBLW，<1500 g）的新生儿的短期结局。设计基于回顾性医院研究的人群，位于南非开普敦。结果在1579名母亲中，有316名（20％）的HIV阳性。183/316（58％）接受了≥8周的产前抗逆转录病毒治疗。暴露于HIV的新生儿（HIVE与未暴露HIV的HIVU）发生坏死性小肠结肠炎（NEC； OR 1.93，95％CI 1.27-2.92）和有创通气（OR 1.35，95％CI 1.01-1.79）的风险增加。极低的出生体重（ELBW，<1000 g）改变了HIV暴露与死亡的关系：在ELBW新生儿中，HIVE vs HIVU死亡率为1.75（95％CI 1.13-2.69）；在非ELBW中，或0.89（95％CI 0.54-1.49）。抗逆转录病毒药物（≥8vs <8周/无）降低NEC（OR 0.46，95％CI 0.22-0.97）和有创通气风险（OR 0.57，95％CI 0.32-0.99）。HIV-PCR结果可用于228/316（72％）HIVE新生儿。11/228（5％）呈阳性。结论在VLBW新生儿中，HIV暴露与短期不良结局的风险增加有关。产前抗逆转录病毒药物具有保护作用。