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Congenital human immunodeficiency virus (HIV) infection in the Bahamas
H Howard-Gardiner1, P D Roberts, P M Dunn
1Department of Child Health, Princess Margaret Hospital, Nassau, Bahamas.
Insights
Twenty-seven children were diagnosed with human immunodeficiency virus (HIV) infection between 1985-1986. Most mothers were asymptomatic and Haitian, questioning the effectiveness of selective HIV screening in the Caribbean.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Human Immunodeficiency Virus (HIV) infection poses a significant global health challenge, particularly in pediatric populations.
- Understanding the transmission dynamics and clinical presentation of HIV in infants is crucial for effective management and prevention strategies.
Purpose of the Study:
- To describe the clinical course and outcomes of HIV-positive children diagnosed at Princess Margaret Hospital, Nassau.
- To evaluate the serostatus and health outcomes of mothers of HIV-positive children.
- To assess the implications of these findings for HIV screening strategies in Afro-Caribbean countries.
Main Methods:
- Retrospective case series analysis of pediatric HIV cases.
- Clinical data collection on disease progression and symptoms.
- Maternal screening for HIV serostatus and risk factor assessment.
- Follow-up of maternal health and pregnancy outcomes.
Main Results:
- Twenty-seven children were diagnosed with HIV infection over a 13-month period.
- Nineteen children presented with acquired immunodeficiency syndrome (AIDS), while others were in prodromal or asymptomatic stages.
- Of 18 mothers, 16 were HIV-seropositive and asymptomatic; nine had subsequent pregnancies with no apparent health decline.
- Fifteen mothers were of Haitian origin, with limited other identified risk factors.
Conclusions:
- The study highlights a significant pediatric HIV burden in Nassau during the specified period.
- Maternal HIV seropositivity was common and often asymptomatic, with good outcomes in subsequent pregnancies.
- The findings challenge the efficacy of selective HIV screening based on risk factors in Afro-Caribbean populations, suggesting broader screening approaches may be necessary.
Abstract:
In the 13-month period between June 1985 and July 1986, 27 children were found to be HIV positive in the Princess Margaret Hospital in Nassau. Nineteen of the children had clinical AIDS, four were in the prodromal phase and four were symptom free. The clinical course of these infants is presented. Of the 18 mothers 16 were screened and were all seropositive and asymptomatic. They remained healthy in spite of subsequent pregnancies in nine of them (56%) during a follow-up period of between 13 and 65 months (mean 40 months). Fifteen of the 18 mothers were Haitian but only three had other risk factors, throwing doubt on the value of selective screening in Afro-Caribbean countries.