Increased morbidity in early childhood among HIV-exposed uninfected children in Uganda is associated with breastfeeding duration

J Trop Pediatr. 2014 Dec;60(6):434-41. doi: 10.1093/tropej/fmu045. Epub 2014 Aug 21.


Human immunodeficiency virus (HIV)-exposed uninfected children (HEU) have an increased risk of morbidity and mortality compared with HIV-unexposed uninfected children (HUU); however, prior studies have not fully accounted for the role of both breastfeeding and age on this association. In this cohort of HEU and HUU in Uganda, non-breastfeeding HEU, from 6-11 months compared with non-breastfeeding HUU had a higher risk of hospitalizations [relative risk (RR): 10.1, 95% confidence interval (CI): 3.70-27.6], severe febrile illness (RR: 3.84, 95% CI: 2.06-7.17), severe diarrhea (RR: 6.37, 95% CI: 2.32-17.4) and severe malnutrition (RR: 18.4, 95% CI: 4.68-72.0). There were no differences between morbidity outcomes between breastfeeding HEU and HUU children, aged 6-11 months. In the 12-24 month age group, the only difference in morbidity outcomes among non-breast feeding children was an increased risk of severe malnutrition for HEU. These data suggest that the increased risk of morbidity among HEU aged 6-11 years is partially explained by early cessation of breastfeeding.

Keywords: Africa; Breastfeeding; HIV; HIV-exposed; Morbidity; Mortality.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Breast Feeding*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Diarrhea / epidemiology*
  • Diarrhea / etiology
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / statistics & numerical data*
  • Male
  • Morbidity
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Rural Population
  • Socioeconomic Factors
  • Uganda / epidemiology
  • Weaning*