Up to 90% of pediatric HIV infections occur through vertical transmission.¹ Infants exposed but not infected with HIV present poorer morbidity and mortality outcomes compared to non-exposed infants, due to factors such as higher rates of prematurity and lower maternal antibody transfer.² This study analyzed outcomes among vertically HIV-exposed children in a tertiary pediatric hospital. Observational and descriptive study based on medical records from a tertiary pediatric hospital. Vertically HIV-exposed children who began follow-up between January 2021 and December 2023 were selected for demographic, epidemiological, and clinical analysis (CAAE:85147424.6.0000.5361). Among 159 confirmed uninfected patients (according to Brazilian Ministry of Health guidelines), 80 (50.3%) attended the emergency department at least once. Of these, 61 (76.2%) presented fever with respiratory symptoms or a diagnosis of respiratory infection; 36 (45%) presented diarrhea or a diagnosis of infectious gastroenteritis; and 30 (37.5%) required at least one hospitalization. Two deaths were recorded, both in presumptively uninfected patients who died before diagnostic confirmation. These outcomes are consistent with meta-analyses describing a high incidence of respiratory and gastrointestinal symptoms, as well as severe infections, in this population. Compared to non-exposed children, this results in an up to 60% increase in all-cause mortality.² These findings highlight the need to strengthen strategies for preventing HIV transmission among women of childbearing age, in order to avoid vertical exposure, which significantly increases morbidity burden in affected children. Additionally, further investigation of the clinical and social impacts of HIV exposure is essential to inform better care planning.
Sarmento et al. (Sun,) studied this question.