Pediatric human immunodeficiency virus infection

Abstract

In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies.

Mucocutaneous manifestations in children with human immunodeficiency virus infection

“…[27,30] Staphylococcal infections are the most common skin infections, usually presenting as cellulitis, ecthyma, erysipelas, furunculosis (occasionally of disseminated nature), persistent and recurrent folliculitis, and impetigo. [17,30,32,34] Mendiratta, et al…”

“…Deep fungal infections: Histoplasma capsulatum, Coccidiodes immitis, Aspergillus fumigatus, Malassezia furfur, Sporothrix schenckii, and others can cause opportunistic infections in HIV-infected adults, [32] but are rarely observed in HIV-infected children. [30] Disseminated sporotrichosis with painful ulcers has been described in children.…”

Clinical manifestations and diagnosis of invasive aspergillosis in immunocompromised children

“…Invasive pulmonary aspergillosis is by far the most common presentation of aspergillosis in children with AIDS [20,45,96,97]. IA was diagnosed in 7 (1.5%) of 473 children with HIV infection followed at the Pediatric Branch of the National Cancer Institute from 1987 to 1995 [77].…”

Hypercalciuria is the main renal abnormality finding in Human Immunodeficiency Virus-infected children in Venezuela

“…Kidney damage may be the result of tissue infiltration by lymphocytes, plasma cells or monocytes [50], heparin binding growth factors or chemokine recruitment [11], or due to the HIV viral expression per se [31,49]. Opportunistic infections and associated malnutrition affect the kidney as well [17,18]. Further, lactic acidosis, kidney stones, and renal tubular injury are known to be associated with specific antiretroviral therapies [55].…”