Paediatric HIV: the experience in Ireland 2004-2011
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Published on: May 30, 2013
N Al-Assaf1, C O Maoldomhnaigh, P Gavin
1Rainbow Clinic, Our Lady's Children's Hospital, Crumlin, Dublin 12.
Insights
Paediatric HIV infection persists in Ireland, with many children diagnosed late. Targeted strategies are needed for pregnant women and proactive HIV testing to improve outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Paediatric HIV infection, despite prevention, remains a concern in Ireland.
- Understanding presentation and management barriers is crucial for improving care.
- Retrospective chart review to analyze cases from 2004-2011.
Purpose of the Study:
- To characterize the presentation of paediatric HIV infection in Ireland.
- To identify barriers to optimal management of HIV-infected children.
- To inform targeted strategies for prevention and early diagnosis.
Main Methods:
- Retrospective chart review of HIV-infected children presenting in Ireland between 2004 and 2011.
- Data collection on demographics, diagnosis timing, disease stage, and treatment exposure.
- Analysis of factors contributing to late diagnosis and management challenges.
Main Results:
- Forty-two children with HIV were identified; median age at presentation was 6 years.
- The majority (90%) were born to African mothers; 26% were born in Ireland.
- A significant proportion (59%) were diagnosed late, with 11 symptomatic cases.
- Foreign-born children often had antiretroviral exposure with resistance mutations.
- Children with advanced disease were frequently hospitalized before diagnosis.
Conclusions:
- Late diagnosis of paediatric HIV is common, necessitating proactive testing strategies.
- Maternal factors like non-adherence and in-pregnancy seroconversion hinder eradication goals.
- Targeted interventions for at-risk pregnant women are essential.
- Improved antenatal screening and postnatal follow-up are required.
Abstract:
Despite effective prevention strategies paediatric HIV infection remains an important condition in Ireland. To characterise presentation and identify barriers to optimal management a retrospective chart review of HIV-infected children presenting in Ireland, 2004-2011 was undertaken. Forty-two HIV-infected children were identified; (25 male). Median age at presentation was 6 years (range 0-16 years). 38 children (90%) were born to African mothers. Eleven (26%) were born in Ireland. Twenty-five (59%) were late diagnoses; 11 were symptomatic. Ten of 12 foreign born HIV-infected children had antiretroviral exposure with frequent resistance associated mutations. Seven of 8 children with stage C disease had previously been admitted to hospital in Ireland before diagnosis. Maternal non-adherence to recommendations and seroconversion in pregnancy challenge the goal of paediatric HIV eradication. Targeted strategies for women at risk of infection in pregnancy are required. Late HIV diagnosis remains common, highlighting the need for a more proactive approach to HIV testing.
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