Relation of the Course of HIV Infection in Children to the Severity of the Disease in Their Mothers at Delivery

Blanche, Stéphane; Mayaux, Marie-Jeanne; Rouzioux, C.; Teglas, Jean Paul; Firtion, Ghislaine; Monpoux, Fabrice; Ciraru-Vigneron, N; Meier, Flurina; Tricoire, J; Courpotin, C

doi:10.1056/nejm199402033300502

Cited by 193 publications

(59 citation statements)

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“…The cumulative mortality rate of Group IIa at 36 months was 25%. This is comparable to the 19% mortality rate observed by the French Pediatric HIV Infection Study Group at 36 months [20,21].…”

Section: Discussionsupporting

confidence: 83%

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

Kattan¹,

Peavy²,

Kalica³

et al. 1996

Journal of Clinical Epidemiology

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The P 2 C 2 HIV Study is a prospective natural history study initiated by the National Heart, Lung, and Blood Institute in order to describe the types and incidence of cardiovascular and pulmonary disorders that occur in children with vertically transmitted HIV infection (i.e., transmitted from mother to child in utero or perinatally). This article describes the study design and methods. Patients were recruited from five clinical centers in the United States. The cohort is composed of 205 infants and children enrolled after 28 days of age (Group I) and 612 fetuses and infants of HIV-infected mothers, enrolled prenatally (73%) or postnatally at age <28 days (Group II). The maternal-to-infant transmission rate in Group II was 17%. The HIV-negative infants in Group II (Group IIb) serves as a control group for the HIV-infected children (Group IIa). The cohort is followed at specified intervals for clinical examination, cardiac, pulmonary, immunologic, and infectious studies and for intercurrent illnesses. In Group IIa, the cumulative loss-to-follow-up rate at 3 years was 10.5%, and the 3-year cumulative mortality rate was 24.9%. The findings will be relevant to clinical and epidemiologic aspects of HIV infection in children.

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Section: Discussionsupporting

confidence: 83%

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

Kattan¹,

Peavy²,

Kalica³

et al. 1996

Journal of Clinical Epidemiology

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“…12 In perinatally infected infants, the rate of maternal transmission and disease progression appears to correlate with maternal virus burden as well as the timing of infection. [13][14][15] In this study, both groups of HIV-infected children who survived until at least 8 years of age had relatively similar clinical profiles.…”

Section: Discussionmentioning

confidence: 99%

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

Nielsen

McSherry

Petru³

et al. 1997

Pediatrics

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ABSTRACT. Objective. To identify the population of human immunodeficiency virus-infected pediatric longterm survivors (LTS) followed in major medical institutions in California, Florida and New Jersey.Methods. A cross-sectional survey was performed with data collection forms sent to all investigators. Demographic, clinical, and laboratory data were obtained on all living patients 8 years infected in the perinatal period with human immunodeficiency virus.Results. A total of 143 perinatally infected and 54 children infected by neonatal transfusion were identified. Fifty-four children (27%) had absolute CD4 counts 500 cells/mm 3 (group 1: mean age 9.8 years), 54 children (27%) had CD4 counts between 200 and 500 cells/mm 3 (group 2: mean age 10.1 years), and 89 children (45%) had CD4 counts <200 cells/mm 3 (group 3: mean age 10.4 years). Ninety-five (48%) patients had developed AIDS defining conditions; 14 (26%) in group 1, 26 (48%) in group 2, and 55 (62%) in group 3. Ninety-two percent of patients had received antiretrovirals. Perinatally human immunodeficiency virus-infected children tended to be younger (mean age 9.8 years) than children infected via a blood transfusion (mean age 11 years). Generalized lymphadenopathy was the most prevalent clinical finding. Lymphoid interstitial pneumonia and recurrent bacterial infections were the most prevalent acquired immune deficiency syndrome-defining conditions. Twenty percent of LTS had CD4 counts 500 cells/mm 3 and no immune deficiency syndrome-defining conditions.Conclusions. Pediatric LTS were in variable stages of disease progression. The proportion of children within each CD4 strata did not differ by mode of acquisition of infection. Increased CD4 counts were inversely proportional to age. Only 20% of pediatric LTS had minimal to no disease progression. Pediatrics 1997;99(4). URL: http: //www.pediatrics.org/cgi/content/full/99/4/e4; HIV, pediatric long-term survivors, slow disease progression.

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“…A bimodal clinical evolution of disease was identified more than a decade ago in vertically HIV-1-infected children who lived in industrialized countries, with children who were infected in utero having a more acute and rapidly evolving HIV disease than those who were infected later. 2 Besides timing of transmission, 3 maternal characteristics (eg, health status, gestational age), 4 and viral phenotypes, 5 children's age-related CD4 ϩ T-cell count has been identified as a major independent and early predictor of disease progression or death in children. 6 Since assays that quantify plasma HIV-1 RNA copy number have become available, HIV-1 dynamics have been well characterized during primary infection in adults [7][8][9] and in perinatally infected children.…”

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confidence: 99%

Pediatric Viral Human Immunodeficiency Virus Type 1 RNA Levels, Timing of Infection, and Disease Progression in African HIV-1-Infected Children

Raffi

Sakarovitch²,

Msellati³

et al. 2003

Pediatrics

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ABSTRACT. Objective. To describe plasma human immunodeficiency virus type 1 (HIV-1) RNA levels in African HIV-1-infected children in relation to the timing of infection and disease progression.Methods. A retrospective cohort study was conducted of 80 children who were born to HIV-1-positive mothers and clinically followed from birth to 18 months of age in the ANRS 049 Ditrame project, Abidjan, Cô te d'Ivoire (West Africa). The diagnosis and timing of pediatric HIV-1 infection were determined prospectively according to HIV-1 DNA polymerase chain reaction results. A total of 364 HIV-1 RNA viral load (VL) measurements were assessed retrospectively. Kaplan-Meier analyses and proportional hazards models were used to evaluate the prognostic value of pediatric VL and covariates for HIV disease progression or death.Results. Mean initial positive VL was significantly lower among children who were infected in utero (4.94 log 10 /mL, n ‫؍‬ 12) than in children who were infected later (5.6 -6.1 log 10 /mL, n ‫؍‬ 68). In the first 6 months after diagnosis, HIV-1 RNA levels peaked (>6 log 10 /mL), regardless of timing of infection. Then, a slow decline (overall slope, ؊0.076 log 10 copies/mL/mo) was observed until 18 months of age. A 1 log 10 higher value of the pediatric peak VL (risk ratio [

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Relation of the Course of HIV Infection in Children to the Severity of the Disease in Their Mothers at Delivery

Abstract: In infants whose HIV infection is maternally acquired, the rate of disease progression varies directly with the severity of the disease in the mother at the time of delivery.

Cited by 193 publications

References 14 publications

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

Pediatric Viral Human Immunodeficiency Virus Type 1 RNA Levels, Timing of Infection, and Disease Progression in African HIV-1-Infected Children

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