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Published on: June 11, 2011
[Clinical aspects and complete blood counts in children exposed to HIV-1: comparison between infected patients and
E B Silva1, H Z Grotto, M M Vilela
1Universidade Estadual de Campinas (UNICAMP), SP, Brazil.
Insights
Children infected with human immunodeficiency virus type 1 (HIV-1) vertically showed earlier monocytosis and lymphopenia. Infected children also experienced more anemia, microcytosis, and hypochromia compared to uninfected or seroreverted children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Vertical transmission of HIV-1 poses significant health risks to children.
- Understanding the clinical and hematological evolution in vertically infected children is crucial for timely intervention.
Purpose of the Study:
- To analyze the clinical and hematological progression in children exposed to HIV-1 through vertical transmission.
- To compare outcomes between infected children and those uninfected or who seroreverted.
Main Methods:
- A prospective, descriptive, longitudinal study of 79 children born to HIV-1 infected mothers.
- Clinical follow-up was conducted from March 1996 to November 1997.
Main Results:
- Failure to thrive was more prevalent in seroreverters.
- Anemia (73.1%) and specific hematological alterations like microcytosis, hypochromia, monocytosis, and lymphopenia were significantly more common in infected children.
- Clinical manifestations were observed in 69.2% of infected children under one year old.
Conclusions:
- Vertically HIV-1 infected children exhibit distinct hematological profiles, including microcytic/hypochromic anemia (likely anemia of chronic disease) and earlier onset of monocytosis and lymphopenia.
- Uninfected children with similar anemia likely had iron deficiency.
- Early identification of these hematological changes is vital for managing HIV-1-exposed infants.
Abstract:
OBJECTIVE: To analyze the evolution of clinical and hematological aspects of children exposed to the vertical transmission of HIV-1, comparing infected patients with uninfected ones or seroreverters. METHODS: Prospective, descriptive, longitudinal study. We analyzed 79 children born from HIV-1 infected mothers, under clinical follow up from March, 1996 until November, 1997, at the Immunodeficiency division of the Hospital de Clínicas da Unicamp (State University Hospital of Campinas). RESULTS: Failure to thrive was observed in both groups, but was greater among seroreverters. Among the infected children, 23 mothers did not use AZT during pregnancy, 16 of them (61.5%) had been breastfed, four were classified into clinical category N, seven into A and fifteen into B. Clinical manifestations in patients younger than one year were seen in 18 infected children (69.2%). Anemia was observed in 73.1% of the infected group and in 41.5% of the seroreverters (P<0.008). The comparison between the groups showed that the most common hematologic alterations in the infected children was microcytosis and hypochromia (P<0.05), lymphopenia between 15 and 18 months (P<0.05), monocytosis between 9 and 12 months (P<0.05) and a tendency towards high ferritin levels, with no statistical significance. CONCLUSIONS: Microcytic and hypochromic anemia were observed in both groups: iron deficiency in the uninfected children, and chronic disease anemia in the infected ones. The infected children presented with monocytosis and lymphopenia at an earlier stage.
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