Disease in children infected with HIV in Abidjan, Cote d'Ivoire

Lucas, Sebastian; Peacock, Christopher; Hounnou, A.; Brattegaard, K.; Koffi, K.; Hondé, M.; Andoh, J.; Bell, Jeanne E.; Cock, Kevin M. De

doi:10.1136/bmj.312.7027.335

Cited by 153 publications

(64 citation statements)

References 18 publications

(21 reference statements)

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“…Several of the reported HIV-infected children with measles coinfections in the United States presented with either no rash or an uncharacteristic rash (18, 20, 61, 86, 97, 109), and 6 of the 19 reported cases resulted in death during the acute illness, usually caused by giant-cell pneumonia (32, 79). Several cases of MV encephalitis in HIV-infected individuals have also been reported (11,16,60,67,85,108,127). In fact, in an autopsy study of MV-infected patients in the Ivory Coast, MV was identified in the central nervous system in 3 of 13 HIV-infected patients and none of 5 non-HIV-infected patients (76).…”

Section: Infection In the Immunocompromised Hostmentioning

confidence: 99%

Immune Containment and Consequences of Measles Virus Infection in Healthy and Immunocompromised Individuals

Permar

Griffin

Letvin

2006

Clin Vaccine Immunol

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2The pathogenicity of measles virus (MV) is intimately linked to the immune status of the infected individual. Measles is typically a self-limiting disease; however, individuals who are immunocompromised (56,79), malnourished (26,78,113), or at the extremes of age (23) are at increased risk for severe measles. At the present time, with human immunodeficiency virus (HIV) and immunosuppressive drug therapy affecting the immune competence of large numbers of individuals, MV is reemerging as an important pathogen worldwide. Elucidating the mechanism by which the immune system controls MV infection and prevents reinfection will be crucial for our understanding of disease pathogenesis and transmission as well as the development of novel MV vaccination strategies.Despite reaching global measles vaccination coverage of Ͼ80% of individuals, MV remains the fifth leading cause of death and the most common cause of vaccine-preventable death in children under 5 years of age (84). An estimated 31 million cases of measles occurred globally in 2001, resulting in 777,000 deaths, the majority (452,000) of which occurred in sub-Saharan Africa (84). MV is one of the most contagious pathogens known to humans, and large measles outbreaks, facilitated by overcrowding in poor communities, continue to occur even in countries that have achieved high vaccine coverage.MV is a 15-kilobase, enveloped, negative-strand RNA virus and a member of the Morbillivirus genus of the Paramyxoviridae family. MV infects only humans and nonhuman primates. It is a stable, monotypic virus, making it an excellent candidate for eventual eradication. In culture, MV can be adapted to grow in nonprimate cells, a process that has facilitated the attenuation of viral strains for the development of a safe vaccine. Measles is transmitted via direct person-to-person contact and causes a symptomatic viral prodrome culminating in the hallmark maculopapular measles rash. The measles rash is preceded by systemic viremia and lymphopenia, and clearance of the rash is followed by a transient suppression of T-lymphocyte responses that lasts several weeks, leaving the infected individual susceptible to other infections.While nonspecific innate immune mechanisms may be important in the control of MV during the first days following infection, adaptive MV-specific immune responses mediate viral clearance and provide protection against subsequent MV infections. Natural MV infection generates long-lasting immunity that includes both MV-specific antibody (14) and memory T-lymphocyte (50, 123, 136) responses. Long-term protection from reinfection occurs without a requirement for reexposure (98).This article reviews our current understanding of the immune control of MV and the consequences of MV infection on the immune system of the immunocompetent host. We then discuss the clinical consequences of MV infection in immunocompromised individuals. Finally, we describe recent studies that have raised questions regarding the outcome of MV infection in the immunocompromised host. IMMUNE CO...

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Section: Infection In the Immunocompromised Hostmentioning

confidence: 99%

Immune Containment and Consequences of Measles Virus Infection in Healthy and Immunocompromised Individuals

Permar

Griffin

Letvin

2006

Clin Vaccine Immunol

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“…HIV-seropositivity rates among adults and children with tuberculosis range from 20-70%, and there are some countries such as Malawi and Zambia where HIV-seroprevalence rates are consistently above 50%. In Zambia and Cote d'Ivoire, HIV-seroprevalence rates in children aged 1 month to 14 years with tuberculosis are between 10-40%, with the highest overall age-specific HIVseroprevalence being found in children aged 1-4 years (Luo et al 1994;Lucas et al 1996a). In Zambia, one in four pregnant women are infected with HIV (Fylkesnes et al 1997).…”

Section: Tuberculosis and Hiv: Epidemiological Considerationsmentioning

confidence: 96%

“…An idea of the true risk of tuberculosis in these children may be obtained from autopsy studies. One such study in West Africa suggested a low risk (Lucas et al 1996a), but autopsies performed on HIV-positive children in Bulawayo, Zimbabwe (Ikeogu et al 1997), established a diagnosis of tuberculosis in 6 of 122 children (5%), and more recently a large autopsy study of children dying of respiratory illnesses in Zambia has shown that 20% of these children have tuberculosis across a wide range of age groups and HIV status.…”

Section: Tuberculosis In Hiv-infected Childrenmentioning

confidence: 97%

Tuberculosis and Co-infection with the Human Immunodeficiency Virus

Zumla

Grange

2004

Tuberculosis

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“…The appearance of chronic muco-cutaneous herpes simplex infection, oesophageal candidosis, chronic cryptosporidial diarrhoea, wasting syndrome and Kaposi's sarcoma were the commonest conditions de®ning entry of HIV-infected patients into WHO stage 4 (AIDS) in a Ugandan study of adults [3]. In contrast, in infants with AIDS, Pneumocystis carinii pneumonia is a common cause of morbidity and mortality [4], with up to 30% of children under 1 year having evidence of infection at post mortem [5].…”

Section: Introductionmentioning

confidence: 99%