Given the potential of Cotrimoxazole preventive therapy (CPT) to prevent bacterial and malarial infections in HIV exposed, uninfected (HEU) infants, it is important to evaluate the effects of its concurrent use with ARV agents that have overlapping toxicity profiles.
We used data from the Breastfeeding, Antiretrovirals and Nutrition-BAN study (2004-2010) to evaluate the association of CPT and ARV with hematologic measures (hemoglobin, neutrophil, and alanine aminotransferase levels) from 6 to 48 weeks of age in 2,006 HEU infants in Lilongwe, Malawi. Hazards of severe outcomes (anemia, neutropenia, and elevated alanine aminotransferase), as defined by the National Institutes of Health, were compared using Cox regression models according to time-varying CPT (implemented June 2006), ARV treatment arm (maternal triple ARV, infant nevirapine, or none during six months of breastfeeding) and their interaction. The effects of these treatments on hemoglobin, neutrophil and alanine aminotransferase levels were assessed using linear mixed models.
In Cox models, CPT was associated with an increase in severe neutropenia (Hazard ratio, HR: 1.97 [1.01, 3.86]) and a decrease in severe anemia (HR: 0.65 [0.48, 0.88]). Interactions between CPT and ARV were not significant. By 36 weeks, there was a significant association of CPT with increased hemoglobin levels regardless of ARV exposure.
In addition to expected associations with increased hazard of severe neutropenia and decreased neutrophil count, CPT was associated with reduced hazard of severe anemia and higher infant blood hemoglobin. This provides further support for CPT use in HEU infants in malaria-endemic resource-limited settings where anemia is prevalent.
Pharmacology, Toxicology and Pharmaceutical Science
4
4%
Other
12
13%
Unknown
34
37%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2019.
All research outputs
#8,264,793
of 25,382,440 outputs
Outputs from AIDS
#2,497
of 6,481 outputs
Outputs of similar age
#151,694
of 446,708 outputs
Outputs of similar age from AIDS
#25
of 65 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one has received more attention than most of these and is in the 66th percentile.
So far Altmetric has tracked 6,481 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has gotten more attention than average, scoring higher than 60% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 446,708 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.
We're also able to compare this research output to 65 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.
