Reply to Slogrove et al
Notice bibliographique
Résumé
We would like to thank Slogrove and colleagues for the positive comments on our manuscript and for emphasizing the need to provide definitive evidence of the benefit of controlling maternal human immunodeficiency virus (HIV) infections for the health of infants born in low- and middle-income countries (LMIC), where the burden of HIV infection is highest [1]. We agree that the pathways leading to the vulnerability of HIV-exposed, uninfected (HEU) infants may not be identical in LMIC and in high-income countries (HIC), and that the potential role of specific factors has to be determined. As proposed by Slogrove and colleagues, the decreased risk of hospitalization observed in our study for those infections associated with the initiation of antiretroviral therapy (ART) before pregnancy may be offset by an increased risk of premature delivery in women living in LMIC [2]. On the other hand, contrary to HIC, women living with HIV in LMIC are encouraged to breastfeed. Although the evidence from HIC is less consistent [3], there is strong supportive evidence for a protective effect of breastfeeding on infectious morbidity in LMIC [4]. Through a diversity of immunological components, breastfeeding could reduce the immunological risk of severe infections after birth and thereby mitigate the impact of immune alterations induced by in utero exposure to maternal HIV infection. In our study, maternal and newborn immune activation predicted the risk of hospitalization due to infection in infants born to mothers who initiated ART during pregnancy [5]. Immune activation is commonly observed in adults living in LMIC, independently of HIV infection [6]. Therefore, the potential for ART to correct immune activation in women living with HIV may be lower in LMIC as compared to HIC, and this could mitigate the impact of ART initiation before pregnancy on infants’ susceptibility to infectious diseases. Although the vulnerability of HEU infants living in different settings could involve different factors, it is essential to recognize that this vulnerability is a global public health issue. An increased susceptibility of HEU infants to severe infections is observed in both LMIC and HIC, suggesting that common determinants are playing a critical role [7, 8]. Identifying these determinants has the potential to positively impact the health of HEU infants worldwide. To meet this challenge, researchers in HIC and LMIC should join efforts and integrate both intensive studies on relatively small study populations and larger studies that are powered to determine the impact of key environmental factors on clinical outcomes. Control of maternal HIV infection before pregnancy and progress in our understanding of the immunobiology of infant exposure to maternal HIV infection provide unprecedented opportunities to further improve the health of children born to HIV-infected mothers. Potential conflicts of interest. A. M.’s institution has received fees from GlaxoSmithKline Vaccines, outside the submitted work. G. A.’s institution has received grants from Gilead Sciences and the Bill and Melinda Gates Foundation (grant numbers OPP1032817, OPP1097381, and OPP1114729). T. R. K.’s institution has received grants from the National Institute for Allergy and Infectious Diseases and the Canada Institutes for Health Research. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,042 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,003 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,052 | 0,032 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,012 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».