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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
13:58

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

Vertically transmitted HIV infection having first clinical manifestations at 13 y of age

Amitabh Sagar1, Biju Vasudevan

  • 1Department Internal Medicine, Armed Forces Medical College, Pune, 411040, Maharashtra, India. amitthephysician@gmail.com

Indian Journal of Pediatrics
|December 30, 2011
PubMed

Insights

A 13-year-old survived vertically transmitted human immunodeficiency virus (HIV) without treatment until developing AIDS. Prompt treatment led to full recovery, highlighting the importance of early antiretroviral therapy (ART) for pediatric HIV.

Area of Science:

  • Pediatric Infectious Diseases
  • Viral Immunology
  • Public Health

Background:

  • Untreated vertically transmitted HIV infection has a high mortality rate in early childhood.
  • Delayed diagnosis and loss to follow-up pose significant challenges in managing pediatric HIV.
  • The natural history of untreated pediatric HIV infection often leads to rapid disease progression and opportunistic infections.

Observation:

  • A case of a 13-year-old boy with vertically transmitted HIV, lost to follow-up since infancy, presented with advanced Acquired Immunodeficiency Syndrome (AIDS).
  • The patient exhibited severe opportunistic infections including Pneumocystis jirovecii pneumonia (PJP), disseminated tuberculosis, Herpes Simplex Type 1 (HSV-1), and systemic candidiasis.
  • Initial presentation included shock, anemia, malnutrition, and oral candidiasis, with a CD4 count of 41 cells/μl.

Findings:

  • The boy received a comprehensive treatment regimen including sulphamethoxazole/trimethoprim (SXTM), anti-tubercular therapy, fluconazole, and antiretroviral therapy (ART).
  • Following treatment, the patient achieved full recovery within two months, demonstrating a significant clinical improvement.
  • This case highlights the potential for long-term survival in vertically transmitted HIV cases even with delayed intervention.

Implications:

  • Early and consistent antiretroviral therapy (ART) during antenatal care and post-birth is crucial for preventing rapid progression of pediatric HIV.
  • Improved access to and adherence to ART can enable more children with vertically transmitted HIV to survive into adolescence and adulthood.
  • This case underscores the importance of follow-up care and timely medical intervention in improving outcomes for children living with HIV.

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