Survival, Disease Manifestations, and Early Predictors of Disease Progression Among Children With Perinatal Human Immunodeficiency Virus Infection in Thailand

Chearskul, Sanay; Chotpitayasunondh, Tawee; Simonds, R. J.; Wanprapar, Nirun; Waranawat, Naris; Punpanich, Warunee; Chokephaibulkit, Kulkanya; Mock, Philip A.; Neeyapun, Kanchana; Jetsawang, Bongkoch; Teeraratkul, Achara; Supapol, Wendy Bhanich; Mastro, Timothy D.; Shaffer, Nathan

doi:10.1542/peds.110.2.e25

Cited by 41 publications

(29 citation statements)

References 27 publications

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“…Finally, consistent with previous reports, 26,28 HIV-exposed infants whose mothers have advanced compared with less advanced HIV disease, are not only more likely to become infected, but are also more likely to die, whether infected or not. In a recent study among HIV-exposed Kenyan infants, high maternal viral load and HIV-1-specific antibody concentration were associated with a significant reduction in maternofetal transfer of measles IgG.…”

Section: Discussionsupporting

confidence: 91%

Child Mortality According to Maternal and Infant HIV Status in Zimbabwe

Marinda

Humphrey

Iliff

et al. 2007

Pediatric Infectious Disease Journal

281

282

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Perinatally infected infants are at particular risk of death between 2 and 6 months: cotrimoxazole prophylaxis and early pediatric HAART should be scaled up. Uninfected infants of infected mothers have at least twice the mortality risk of infants born to uninfected mothers: all HIV-exposed infants should be targeted with child survival interventions. HIV-positive mothers with more advanced disease are not only more likely to infect their infants, but their infants are more likely to die, whether infected or not: provision of antiretroviral treatment to pregnant and lactating women is an urgent need for both mothers and their children.

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Section: Discussionsupporting

confidence: 91%

Child Mortality According to Maternal and Infant HIV Status in Zimbabwe

Marinda

Humphrey

Iliff

et al. 2007

Pediatric Infectious Disease Journal

281

282

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“…Pneumonia was seen in 47, 43 and 26 percent of patients in Mexico (18), Addis Ababa (9) and Cote d'Ivoire (19) respectively. In a study in Thailand pneumonia was the cause of death in 52% of the patients (20). Special staining techniques used to diagnose pneumocystis carinii pneumonia in Zimbabwe showed a prevalence rate of 16% (21), figure wise this is comparable to our finding.…”

Section: Ethiopjhealth Dev 2005;19(1)supporting

confidence: 87%

Clinical Manifestations of HIV/AIDS in Children in Northwest Ethiopia

Asnake¹,

Amsalu²

2005

Ethiopian Journal of Health Development

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Background: Pediatric HIV infection is a major world health problem, which is progressing at an alarming rate. Children with AIDS compared to immune competent ones present with disease patterns that are different in nature, severity and/or frequency. Objective: To study the clinical profile of HIV/AIDS in children. Methods: A retrospective study of 89 children with symptomatic HIV infection, aimed at evaluating the clinical manifestations of HIV infection in patients admitted to Gondar University Hospital over a period of five years. Results: Eighty nine children having symptomatic HIV infection were studied. Their ages ranged from 16 months to 12 years. The median age was 2.8 years. Majority of the patients were from urban areas. The main presenting complaint were cough and/or difficult breathing 52 (58.4%) and diarrhea 47 (52.8%). Chronic diarrhea was seen in 34.8% of the patients. Commonly seen physical findings on admission were hepatomegaly (53.9%), fever (50.0%), respiratory distress (47.2%), skin lesions (46.1%), generalized lymphadenopathy (41.6%) and splenomegaly (29.2%). Neurological manifestations included developmental delay, microcephaly and seizure disorder. Most of the patients were malnourished. The main diseases that were identified were tuberculosis (70.9%), pneumonia (43.8%), oral thrush (25.8%) and chronic ear infection (24.7%). Eight (9%) of the patients died in the hospital. IntroductionPediatric HIV is a major world health problem, which is progressing at an alarming rate. In most cases it is due to transmission from HIV seropositive mothers during pregnancy, delivery or breast feeding (1-3). In two Ugandan studies 98% of the mothers of children with HIV infection were found seropositive when tested for the virus (4,5). As the majority of children become infected through mother to child transmission, perinatally acquired infection will parallel increase in heterosexual transmission and the numbers of infected women of childbearing age. Different studies show the rate of vertical transmission range from 14-39% (6) and a study in Ethiopian children estimated the risk of transmission to be 29-47% (7).

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“…19 There is little information about HIV-infected children with LIP in Asian countries. 20,21 The pathogenesis of LIP in patients with HIV infection is not known. It is believed that it represents a tissue response to EBV infection, HIV infection of the lung, or both.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

Bhoopat

Rangkakulnuwat²,

Ya-In³

et al. 2011

Applied Immunohistochemistry &Amp; Molecular Morphology

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Lymphocytic interstitial pneumonia (LIP) is an uncommon histopathologic entity characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes and other lymphoid elements. An increased incidence of LIP has been seen in the pediatric population, especially in children with acquired immune deficiency syndrome. Our previous study supports the notion that Langerhans cells (LCs) are reservoirs for Epstein-Barr virus (EBV) in lungs of human immunodeficiency virus (HIV) subtype E-infected pediatric LIP. To further understand the pathogenesis of LIP, we studied the relationship between EBV, the suggested causative agent of LIP and HIV-1 capsid protein p24, which play an important role in the interaction with host proteins during HIV-1 adsorption, membrane fusion, and entry in surgical lung biopsy-proven LIP from 9 vertically HIV subtype E-infected pediatric patients. The dominant microscopic feature of LIP demonstrated widespread widening of alveolar septum by mononuclear inflammatory cell infiltrate, mainly composed of mature lymphocytes and plasma cells surrounding airways and expanding to the lung interstitium. EBV-encoded RNA (EBER) in situ hybridization (ISH) and p24 immunohistochemistry, performed on formalin-fixed, paraffin-embedded tissue from open lung biopsy specimens, revealed positive intranuclear EBER signals and intracytoplasmic immunostains for p24 core protein in all 9 LIP cases. By combining ISH and immunohistochemistry, these results suggest that (i) EBV/p24-carrying cells are likely involved in the development of LIP, either directly or indirectly; (ii) LCs and related dendritic cells are the main reservoir of both EBV and HIV subtype E in pediatric LIP and possibly LCs may play an important role in the recruitment of inflammatory cell infiltrates, especially T cells into these tissues; (iii) coexpression of EBV/p24 in bronchioalveolar epithelium supports the hypothesis that these cells serve as a reactivation source for both viruses to achieve greater quantities in alveolar septum and interstitium around bronchioles. These results indicate a strong association between the presence of HIV core protein p24 and expression of EBV RNA transcripts (EBER). Interactions between LCs and related dendritic cells together with T cells are important for effective HIV and EBV replications. The coexpression of both viruses could be related to the evolution of pediatric LIP in HIV subtype E infection.

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Survival, Disease Manifestations, and Early Predictors of Disease Progression Among Children With Perinatal Human Immunodeficiency Virus Infection in Thailand

Cited by 41 publications

References 27 publications

Child Mortality According to Maternal and Infant HIV Status in Zimbabwe

Child Mortality According to Maternal and Infant HIV Status in Zimbabwe

Clinical Manifestations of HIV/AIDS in Children in Northwest Ethiopia

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

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