Temporal trend in the time to seroreversion in uninfected infants born to HIV seropositive mothers

Abstract

The time to seroreversion in uninfected infants born to HIV seropositive mothers depends on the level and type of IgG HIV antibodies passed to the infants from the mothers. Secondary analysis of data from three studies conducted in Malawi was done to study whether a temporal trend occurs in the time to seroreversion in these infants as the disease progresses to a more advanced stage in the community. The studies are ICAR (includes infants born from 1989–1991), HIVNET (1993–1996) and NVAZ (2000–2002). The number of infants studied were 635 (ICAR), 459 (HIVNET) and 1020 (NVAZ). Relative odds of seroreversion by the age of 15 months was 5.74 in those born from 1989–1996 as compared to those born from 2000–2002 (p = 0.00). Relative odds of seroreversion by the age of 18 months was 6.79 in those born from 1989–1996 as compared to those born from 2000–2002 (p = 0.002). Children born after 1999 were found to have seroreverted later than children born in or before 1996. This indicates higher IgG antibody levels being passed to infants from HIV seropositive mothers in the later study (NVAZ). These mothers had more advanced stage of HIV/AIDS as the disease had been in Malawi for many years and had reached an epidemic stage leading to higher antibody levels. In conclusion, time to seroreversion in HIV exposed uninfected infants increases as the disease progresses in the community.