Prediction Models for HIV Infection in Infants: Analysis of Scoring Systems on Maternal, Infants, and Mode of Delivery Risk Factors.

IF 0.8 4区医学 Q4 IMMUNOLOGY

Current HIV Research Pub Date : 2024-01-01 DOI:10.2174/011570162X304984240822052915

Debbie Latupeirissa, Arwin A P Akib, Sri Rezeki S Hadinegoro, Fera Ibrahim, Asril Aminullah, Saptawati Bardosono, Ismoedijanto, Budi Utomo

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引用次数: 0

Abstract

Background: Diagnosis for HIV in infants is hard to determine, particularly in limited-resource areas. A delay in the diagnosis of HIV-infected infants will lead to high morbidity and mortality. The purpose of this project is to construct a model of an HIV-positive infant and develop a useful and practical scoring system to estimate the likelihood of mother-to-child transmission that can be applied in the field.

Methods: A cross-sectional study on 100 subjects through medical records of infants born to HIV-infected mothers was conducted at four hospitals and one community health center. Several models of risk prediction scores of HIV-infected infants were then made. Furthermore, the performed validation was performed on 20 subjects of infants born to mothers with HIV in three hospitals by comparing the scoring system and the result of the PCR RNA examination performed at the age of 6 weeks old.

Results: The risk of HIV-infected infants was higher in mothers who did not receive ARV through PMTCT programs (OR 33.6; 95% CI 4.0 to 282.2), pulmonary TB infection (OR 5.1; IK95% 1.6 to 16.0) and vaginal delivery (OR 9.2; IK95 2.2 to 38.0%). Two models can predict the occurrence of infected HIV infants effectively. Model 1 consists of maternal age, maternal ARVs, lung TB infection, gestational age, mode of delivery, and sex of the infants with sensitivity and specificity of 78.9% and 70.8% (AUC=0.817 [95% CI 0.709 to 0.926]) and likelihood ratio score of 4. Model 2 consists of ARVs to the mother, pulmonary TB infection, and mode of delivery with sensitivity and specificity of 73.7% and 86.1%; AUC value of 0.812 (95% CI 0.687 to 0.938) and likelihood ratio of 5. External Validation gave similar results to the Model 2 scoring system with PCR RNA.

Conclusion: The prediction score of HIV-infected infants in Model 2 can be used in newborns of HIV-positive mothers as an effective and practical risk screening tool for HIV-infected infants before the gold standard examination by PCR.

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婴儿感染艾滋病毒的预测模型：产妇、婴儿和分娩方式风险因素评分系统分析。

背景：婴儿的艾滋病诊断很难确定，尤其是在资源有限的地区。延误对感染艾滋病毒婴儿的诊断将导致高发病率和高死亡率。本项目的目的是构建一个 HIV 阳性婴儿的模型，并开发一套实用的评分系统，用于估算母婴传播的可能性：方法：在四家医院和一家社区卫生中心，通过艾滋病病毒感染母亲所生婴儿的医疗记录，对 100 名受试者进行了横断面研究。方法：在四家医院和一家社区卫生中心对 100 名感染艾滋病毒的母亲所生婴儿的医疗记录进行了横断面研究，然后建立了几个艾滋病毒感染婴儿风险预测评分模型。此外，通过比较评分系统和 6 周大时进行的 PCR RNA 检查结果，对三家医院 20 名艾滋病毒感染母亲所生婴儿进行了验证：结果：未通过预防母婴传播项目接受抗逆转录病毒治疗的母亲（OR 33.6；95% CI 4.0 至 282.2）、肺结核感染（OR 5.1；IK95% 1.6 至 16.0）和阴道分娩（OR 9.2；IK95 2.2 至 38.0%）的婴儿感染艾滋病毒的风险较高。有两个模型可以有效预测感染艾滋病病毒婴儿的发生。模型 1 由产妇年龄、产妇抗逆转录病毒药物、肺结核感染、胎龄、分娩方式和婴儿性别组成，灵敏度和特异性分别为 78.9% 和 70.8%（AUC=0.817 [95% CI 0.709 to 0.模型 2 包括母亲的抗逆转录病毒药物、肺结核感染和分娩方式，灵敏度和特异性分别为 73.7% 和 86.1%；AUC 值为 0.812（95% CI 0.687 至 0.938），似然比为 5。外部验证结果与使用 PCR RNA 的模型 2 评分系统相似：结论：模型 2 中的 HIV 感染婴儿预测评分可用于 HIV 阳性母亲的新生儿，是在 PCR 金标准检查之前对 HIV 感染婴儿进行有效、实用的风险筛查工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current HIV Research 医学-病毒学

CiteScore

1.90

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current HIV Research covers all the latest and outstanding developments of HIV research by publishing original research, review articles and guest edited thematic issues. The novel pioneering work in the basic and clinical fields on all areas of HIV research covers: virus replication and gene expression, HIV assembly, virus-cell interaction, viral pathogenesis, epidemiology and transmission, anti-retroviral therapy and adherence, drug discovery, the latest developments in HIV/AIDS vaccines and animal models, mechanisms and interactions with AIDS related diseases, social and public health issues related to HIV disease, and prevention of viral infection. Periodically, the journal invites guest editors to devote an issue on a particular area of HIV research of great interest that increases our understanding of the virus and its complex interaction with the host.