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Occurrence of infections in children infected with human immunodeficiency virus
N Principi1, P Marchisio, R Tornaghi
1Department of Pediatrics (IV), University of Milan Medical School, Italy.
Insights
Human immunodeficiency virus (HIV)-infected children, especially symptomatic ones (P2), experience more infections than healthy peers. Asymptomatic (P1) children had similar infection rates to controls.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Human immunodeficiency virus (HIV) infection in children presents a spectrum of clinical manifestations.
- Understanding the infection burden in asymptomatic versus symptomatic HIV-infected children is crucial for clinical management.
- The Centers for Disease Control (CDC) classification system stratifies HIV disease progression.
Purpose of the Study:
- To compare the incidence of infections in asymptomatic and symptomatic HIV-infected children against immunocompetent controls.
- To determine if specific infections like pneumonia and oral candidiasis are more prevalent in symptomatic HIV-infected children.
- To assess the occurrence of severe infections in different stages of pediatric HIV infection.
Main Methods:
- Prospective comparative cohort study design.
- Individual matching of 27 HIV-infected children with 27 immunocompetent controls.
- Follow-up duration of 543 months, with data analyzed based on CDC P1 (asymptomatic) and P2 (symptomatic) classifications.
Main Results:
- HIV-infected children experienced a higher total number of infectious episodes (185) compared to controls (118).
- Symptomatic (P2) HIV-infected children had significantly more infections (86) than controls (32).
- Pneumonia and oral candidiasis were significantly more frequent in symptomatic HIV-infected children; severe infections were almost exclusive to this group.
Conclusions:
- Symptomatic HIV infection in children is associated with a substantially increased risk of infections, including pneumonia and oral candidiasis.
- Asymptomatic HIV-infected children (P1) demonstrate infection rates comparable to their healthy counterparts.
- Clinical monitoring and intervention are critical for managing infection risk in symptomatic pediatric HIV patients.
Abstract:
To evaluate the occurrence of infections in asymptomatic and symptomatic human immunodeficiency virus (HIV)-infected children we performed a prospective comparative cohort study. Twenty-seven HIV-infected children were individually matched with paired immunocompetent controls and followed up for a total of 543 months (mean per child, 19.4 +/- 11 months). Collected data were evaluated considering HIV-infected children both as a whole and as P1 and P2 patients according to the Centers for Disease Control classification. Twenty-seven HIV-infected children had 185 infectious episodes vs. 27 matched controls who experienced 118 infections. P1 children had a number of infections similar to those of normal controls (99 vs. 86) whereas P2 children had a significantly higher number of infections than did controls (86 vs. 32). Pneumonia and oral candidiasis occurred significantly more frequently in symptomatic HIV-infected children than in normal controls. Severe infections occurred almost exclusively in HIV-infected symptomatic children.