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Demographics in HIV-infected children in Denmark: results from the Danish Paediatric HIV Cohort Study
Johannes Schmid1, Søren Jensen-Fangel, Niels Henrik Valerius
1Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. johannesschmid@dadlnet.dk
Insights
The Danish Paediatric HIV Cohort Study tracked 89 children diagnosed with HIV before age 16. A shift towards perinatal transmission and non-Caucasian ethnicity was observed, suggesting targeted screening for pregnant women from high-risk areas.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- The Danish Paediatric HIV Cohort Study is an observational database tracking HIV in children in Denmark.
- Up to July 2003, 89 children were diagnosed with HIV before age 16.
Purpose of the Study:
- To present demographic data on HIV-infected children in Denmark.
- To analyze trends and characteristics of pediatric HIV infection.
Main Methods:
- Observational study using the Danish Paediatric HIV Cohort Study database.
- Analysis of demographic data, including age at diagnosis, parentage, race, and mode of transmission.
Main Results:
- HIV prevalence and incidence in children were lower than in adults (5.77/100,000 and 0.39/100,000).
- Since 1993, an average of 4.2 new pediatric HIV diagnoses occurred annually.
- A significant proportion of children (58.5%) had at least one parent from an African country.
- 76% of the cohort were infected perinatally, with a trend towards increased perinatal transmission, non-Caucasian race, and younger age at diagnosis.
- Since 1995, many newly diagnosed children were born in Denmark to mothers from high-endemic areas.
Conclusions:
- The HIV epidemic in children in Denmark shows a shift towards perinatal transmission and increased representation of non-Caucasian children.
- Active HIV testing should be offered to pregnant women from high-risk areas, especially those born in Denmark to mothers from high-endemic regions.
Abstract:
We present the demographic data on HIV-infected children from the Danish Paediatric HIV Cohort Study, an observational database on HIV in Denmark. Up to 1 July 2003 a total of 89 children had been diagnosed with HIV infection before the age of 16 y, of which 12 (13.5%) had died, 2 (2.2%) had emigrated from Denmark, and 13 had reached the age of 16 y. Estimates of prevalence and incidence of HIV infection in the area were 5.77/100,000 and 0.39/100,000 respectively, which are lower than in the adult population. After 1993 the number of newly diagnosed HIV infected children remained quite constant with an average of 4.2 diagnoses per y. Of the enrolled patients only 15.7% had both their parents of Danish origin, while 58.5% had at least 1 of the parents from an African country. Of the entire cohort, 20% were Caucasians, 51% were males and 76% were infected perinatally. There has been a shift in the HIV epidemic in children over recent y, with a higher proportion of newly diagnosed HIV patients having contracted the infection perinatally, a higher proportion being of non-Caucasian race, and the newly diagnosed individuals being younger. Even since 1995, a major part of the newly diagnosed children was born in Denmark by mothers from high-endemic areas and we therefore suggest that HIV-testing should actively be offered to all pregnant women coming from these high-risk areas.