The main objective of this study was, on a national level, to investigate the risk of in-hospital admissions and use of antibiotics during the first four years of life among HIV-exposed uninfected (HEU) children compared to a matched control group of HIV-unexposed (HU) children.
A nationwide register-based cohort study.
All HEU children born in Denmark from 2000-2012 were individually matched to five HU controls. Outcomes were risk of hospital admission (any, due to an infectious disease, observation/non-specific diagnosis) and use of antibiotics during the first four years of life. Incidence rate ratios were estimated using Poisson regression analysis.
In total, 317 HEU children and 1581 matched controls were included. HEU children had a three-fold increased risk of overall admissions (IRR 3.49 (95% CI 2.98-4.08)). There was no difference in risk of admission due to infectious diseases (IRR 1.11 (95% CI 0.73-1.70)) and no difference in use of antibiotics (IRR 0.88 (95% CI 0.73 – 1.04). The excess risk/100 PY of admission was primarily caused by an increased risk of admission due to observation/non-specific diagnosis (excess IR 22.6 (95% CI 18.2 – 27.0), IRR 6.06 (95% CI 4.84-7.61)).
HEU children had an increased risk of overall hospital admission mainly due to an increased risk of admission due to observation/non-specific diagnosis. There was no increased risk of admission due to infectious disease. The excess risk of admission among HEU may be related to prophylactic treatment and/or HIV-testing rather than somatic disease related to HIV or exposure to antiretroviral therapy.