Prognostic factors and survival in children with perinatal HIV-1 infection

Tovo, Pier Angelo; Martino, Maria De; Gabiano, Clara; Cappello, N.; D'Elia, R; Loy, Anna; Plebani, A; Zuccotti, G.V.; Dallacasa, P; Ferraris, G; Caselli, D; Fundarò, C.; D’Argenio, Patrizia; Galli, Letizia; Principi, Nicola; Stegagno, M; Ruga, Ezia; Palomba, E

doi:10.1016/0020-7292(93)90799-3

Cited by 67 publications

(93 citation statements)

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“…This study demonstrates differences in this process among federal units analyzed. Some studies showed a mortality of between 25% and 50% in the first year of life of HIV-infected babies and of 85% to 95% during the first five years of life before the adoption of antiretrovirals 23,24 . More recent data about the natural history of mother-to-child HIV infection indicate that the average time of survival has now increased to between 6 and 9 years 25 .…”

Section: Discussionmentioning

confidence: 99%

AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil

Matida

Ramos

Moncau³

et al. 2007

Cad. Saúde Pública

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Antiretroviral therapy contributes to decreasing morbidity and mortality, and ultimately to increasing survival. In Brazil, there are regional differences in HIV epidemiology regarding pregnant women and children with HIV/AIDS. This study evaluates survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, reported between 1983 and 1998 and followed until 2002, in Brazil's five regions. Time between birth and HIV diagnosis decreased over the years, mainly in the South and Southeast Regions. There was a significant improvement in survival; more than 75% of cases were still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities in health care infrastructure it is possible for a developing country to establish an effective system of universal and free access to antiretroviral therapy that produces a significant increase in survival for children with AIDS.

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Section: Discussionmentioning

confidence: 99%

AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil

Matida

Ramos

Moncau³

et al. 2007

Cad. Saúde Pública

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“…[1][2][3][4][5][6] For purposes of this study, the definitions are: 1) RP-had an AIDS-defining condition (other than LIP/PLH), or severe immunosuppression (Centers for Disease Control and Prevention [CDC] immunologic category 3), or both, in the first year of life; 14 and 2) non-rapid progressors (non-RP)-did not meet criteria for rapid progressors.…”

Section: Definitions Of Hiv-1 Disease Progression In Study Subjectsmentioning

confidence: 99%

“…1 In general, children with vertical HIV infection have shorter clinical latent periods and more rapid disease progression than do other individuals with HIV infection. [2][3][4][5][6] The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Study (P 2 C 2 HIV Study) has shown that structural and functional abnormalities of the heart are among the earliest abnormalities to appear in pediatric HIV infection. 7 Pulmonary abnormalities were also found, including a high incidence of acute pneumonia during the first year of life.…”

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confidence: 99%

Alterations in Cardiac and Pulmonary Function in Pediatric Rapid Human Immunodeficiency Virus Type 1 Disease Progressors

et al. 2000

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Objective-Infants with human immunodeficiency virus type 1 (HIV-1) can be divided into rapid progressors (RPs) and non-rapid progressors (non-RPs) based on symptoms and immunologic status, but detailed information about cardiac and pulmonary function in RP and non-RP children needs to be adequately described.Methodology-Cardiac, pulmonary, and immunologic data and HIV-1 RNA burden were periodically measured in 3 groups: group I, 205 vertically infected children enrolled from 1990 to 1994 and followed through 1996; group II, a prospectively studied cohort enrolled at birth that included 93 infected (group IIa); and 463 noninfected infants (group IIb).Results-Mean respiratory rates were generally higher in group IIa RP than non-RP children throughout the period of follow-up, achieving statistical signifance at 1 month, 12 months, 24 months, 30 months, and 48 months of follow-up. Non-RP and group IIb (HIV-uninfected children) had similar mean respiratory rates from birth to 5 years of age. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptSignificant differences in mean respiratory rates were found between group I RP and non-RP at 7 age intervals over the first 6 years of life. Mean respiratory rates were higher in RP than in non-RP at <1 year, 2.0 years, 2.5 years, 3.0 years, 3.5 years, 4.0 years, and 6.0 years of age.Mean heart rates in group IIa RP, non-RP, and group IIb differed at every age. Rapid progressors had higher mean heart rates than non-RP at all ages through 24 months. Mean heart rates at 30 months through 60 months of age were similar for RP and non-RP children. Non-RP children had higher mean heart rates than did group IIb at 8 months, 24 months, 36 months, 42 months, 48 months, 54 months, and 60 months of age.In group I, RP had higher mean heart rates than non-RP at 2.0 years, 2.5 years, 3.0 years, and 4.0 years of age. After 4 years of age, the non-RP and RP had similar mean heart rates.Mean fractional shortening differed between the 3 group II subsets (RP, non-RP, and IIb) at 4, 8, 12, 16, and 20 months of age. Although mean fractional shortening was lower in RP than in non-RP in group II at all time points between 1 and 20 months, the mean fractional shortening was significantly lower in RP only at 8 months when restricting the statistical comparisons to the 2 HIV-infected groups (RP and non-RP). Mean fractional shortening increased in the first 8 months of life followed by a gradual decline through 5 years of age among group IIb children. No significant differences among the 3 groups in mean fractional shortening were detected after 20 months of age.In group I, differences between RP and non-RP in mean fractional shortening were detected at 1.5, 2.0, 2.5, and 3.0 years of age. After 3 years of age, group means for fractional shortening in RP and non-RP did not differ. Because of the limited data from the first months of the group I patients, it could not be determined whether this group experienced the gradual early rise in mean fractional shortening seen in the...

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“…1,2,3 O início da doença em crianças infectadas é variável, mas, em muitas delas, ocorre nos primeiros dezoito meses de vida e geralmente a morbi-mortalidade é significante. 1,4,5 A realização de diagnóstico precoce e confiável de infecção pelo HIV-1 em lactentes é benéfica, pois, permite intervenção com recursos terapêuticos atualmente disponíveis e que modificam a história natural da doença. Assim é que a vigilância de infecções bacterianas e o seu tratamento precoce, o uso de anti-virais, o uso de preparações de imunoglobulinas por via endovenosa e a profilaxia de infecções oportunistas podem melhorar substancialmente Uso da reação em cadeia da polimerase (PCR) para o diagnóstico neonatal de infecção perinatal pelo vírus da imunodeficiência humana tipo 1 (HIV)…”

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Use of polimerase chain reaction for neonatal diagnosis of human immunodeficiency virus type 1 (HIV-1) perinatal infection

Mussi-Pinhata¹,

Ferez²,

Covas³

et al. 1994

J Pediatr (Rio J)

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Pediatria 338 ResumoCom o objetivo de realizar diagnóstico precoce e confiável de infecção perinatal pelo HIV-1 no período neonatal, antes do aparecimento de sinais e sintomas de doença, avaliou-se a utilidade da técnica de reação em cadeia da polimerase (PCR) para o HIV-1 em 37 recém-nascidos (idade mediana de 5.5 dias) de mães infectadas. Das trinta crianças acompanhadas (mediana de 25 meses), 9 (30%) eram infectadas segundo critérios clínicos e sorológicos, e 21(70%) eram não infectadas. Entre os infectados, 5/9 (56%) tiveram teste PCR neonatal ( mediana de 5,5 dias) positivo e em 4/9 (44%) o teste foi negativo. Em nenhuma das 21 crianças não infectadas o teste foi positivo. Não se observou associação entre a positividade do teste PCR neonatal e o prognóstico. Apesar de não identificar todos os casos no período neonatal, este teste é útil para o diagnóstico de infecção perinatal e talvez esteja identificando as crianças infectadas pelo HIV-1 durante a gestação.J. pediatr. (Rio J.). 1994; 70(6):338-343: vírus da imunodeficiencia humana, infecção perinatal, recém-nascido, diagnóstico precoce de infecção pelo HIV-1, reação em cadeia da polimerase. AbstractThe polymerase chain reaction (PCR) was evaluated for its ability to diagnose perinatal HIV-1 infection before the development of signs or symptoms of the disease in thirtyseven infants (median age of 5.5 days) born to HIV-1 infected women. Of 30 children with complete follow up (median of 25 months), 9 (30%) had serological and clinical features of HIV-1 infection and 21 (70%) were uninfected. Among the infected infants, 5/9 (56%) had positive neonatal PCR tests and 4/9 (44%) had negative PCR tests. None of the 21 uninfected children had positive PCR tests. The prognosis of HIV-1 disease in infected infants with a positive neonatal PCR positive test was similar to that of infected infants with a negative PCR test. In spite of not identifying all the infected infants, the PCR test is a useful tool for early diagnosis of HIV-1 perinatal infection, detecting infected newborns during gestation.J. pediatr. (Rio J.). 1994; 70(6):338-343: human immunodeficiency virus, perinatal infection, newborn infant, early diagnosis of HIV-1 infection, polymerase chain reaction.

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Prognostic factors and survival in children with perinatal HIV-1 infection

Cited by 67 publications

References 0 publications

AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil

AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil

Alterations in Cardiac and Pulmonary Function in Pediatric Rapid Human Immunodeficiency Virus Type 1 Disease Progressors

Use of polimerase chain reaction for neonatal diagnosis of human immunodeficiency virus type 1 (HIV-1) perinatal infection

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