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Epidemiology, clinical features, and prognostic factors of paediatric HIV infection. Italian Multicentre Study
Insights
Perinatal human immunodeficiency virus (HIV) infection in children presents varied symptoms and worse outcomes than later infections. Early symptoms and female sex increase mortality risk in perinatally infected infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Human Immunodeficiency Virus (HIV) infection in children poses significant health challenges.
- Understanding transmission routes and prognostic factors is crucial for managing pediatric HIV.
Purpose of the Study:
- To analyze clinical presentations and outcomes of pediatric HIV infection.
- To identify risk factors and prognostic indicators for perinatally infected children.
Main Methods:
- Retrospective study of 486 children born to HIV-positive mothers.
- Comparison of clinical outcomes between perinatal and childhood HIV infection.
- Analysis of transmission rates and associated factors.
Main Results:
- Perinatal HIV infection showed a more varied clinical picture and worse outcomes.
- Severe secondary infections, neurological disorders, and hepatitis were linked to high mortality in perinatally infected children.
- Higher transmission rates were observed in children born via vaginal delivery and breastfed; girls had increased infection and mortality rates.
Conclusions:
- Perinatal HIV infection has a poorer prognosis than infection acquired later in childhood.
- Early symptom onset, specific clinical manifestations, and female sex are associated with increased mortality.
- Transmission prevention strategies should consider delivery mode and breastfeeding in HIV-positive mothers.
Abstract:
486 children born to HIV-positive mothers, 57 children infected by blood products, and 1 child for whom the personal history was not available were studied. Perinatal infection had a more varied clinical picture and a worse outcome compared with infection acquired later in childhood. Severe secondary infections, neurological disorders, and hepatitis (but not lymphoid interstitial pneumonia) were linked to a high mortality rate in perinatally infected children, in whom an early onset of symptoms was also a bad prognostic factor. Perinatal HIV infection occurred in 32.6% of children born to seropositive mothers, with a higher transmission rate in children born by vaginal delivery and then breast-fed. Preterm delivery and low birthweight seemed to be related to drug abuse during pregnancy, not to intrauterine HIV infection. Girls had a higher rate of perinatal infection and, of those infected, had an increased mortality.