1344. Infectious Morbidity and Mortality of HIV-Exposed, Uninfected Infants Compared with HIV-Unexposed Uninfected Infants in Botswana

Abstract Background Studies have shown increased risk for infection-related hospitalizations among infants HIV-exposed-uninfected (HEU) compared to HIV-unexposed-uninfected (HUU). However, limited data exist during an era of expanded antiretroviral therapy (ART) and improved healthcare access in pregnancy. Methods The Tshilo Dikotla study prospectively enrolled pregnant women ≥ 18 years old, both living with HIV (WLHIV) HIV-seronegative, Botswana, following mother-infant pairs through 3 postpartum. Pregnant WLHIV received tenofovir/lamivudine or emtricitabine plus efavirenz dolutegravir. For this analysis, the primary outcome, infectious morbidity, was hospitalization death due cause first 12 months life. Log-binomial models were fit assess association between utero exposure status morbidity. Subgroup analysis HEU performed associations timing maternal ART initiation (pre-conception vs. pregnancy) infant Results Of 464 infants, 314 (67.7%) HEU. Maternal age higher (30.3 24.6 years; p < 0.01), as gravidity (3.0 vs.1.0; 0.01). proportion reporting senior secondary tertiary education lower (43.3% vs 72.0%; p< A total 35 (7.5%) hospitalized/died causes [26 (8.3%) 9 (6.0%) HUU (p=0.38)]. most frequent infections pneumonia diarrhea/gastroenteritis. There no significant difference morbidity by [adjusted Odds Ratio (aOR), 1.17; 95% Confidence Interval (CI), 0.49, 2.81] after adjusting age, gravidity, income, education. No found (aOR 0.60; CI, 0.25, 1.40) who HEU, additionally CD4 count viral load. Characteristics Conclusion In small sub-Saharan African cohort, detectable observed Larger studies are needed confirm these findings. Disclosures All Authors: reported disclosures.