Related Experiment Videos
Older children and adolescents living with perinatally acquired human immunodeficiency virus infection
S Grubman1, E Gross, N Lerner-Weiss
1Department of Pediatrics, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
Insights
Children with perinatally acquired human immunodeficiency virus (HIV) infection beyond age 9 often experience significant symptoms and immune decline. While some remain asymptomatic, many face chronic health challenges impacting daily life.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Adolescent Health
Background:
- Perinatally acquired human immunodeficiency virus (HIV) infection presents unique challenges for long-term survival and development in children.
- Understanding the clinical, immunologic, and psychosocial trajectories of these children is crucial for comprehensive care.
Purpose of the Study:
- To characterize the long-term outcomes of children living with perinatally acquired HIV beyond age 9.
- To describe their clinical status, immune function, and psychosocial well-being.
Main Methods:
- A descriptive cohort study was conducted involving 42 children older than 9 years with perinatally acquired HIV.
- Data on clinical, immunologic, and psychosocial parameters were collected from medical records.
Main Results:
- The cohort, with a mean age of 136 months, showed varied disease progression: 23.8% remained asymptomatic, while 57.1% developed Acquired Immunodeficiency Syndrome (AIDS).
- Significant annual CD4+ cell decline was observed, with 50% having fewer than 200 cells/microL.
- Psychosocially, 76% were orphaned, and 76% attended regular school.
Conclusions:
- A significant proportion of children aged 9-16 with perinatally acquired HIV experience immunologic deterioration and symptomatic disease progression.
- While some survivors maintain relatively intact immune systems, many face chronic health issues impacting their daily lives.
Objective:
To describe the clinical, immunologic, and psychosocial characteristics of children living with perinatally-acquired human immunodeficiency virus (HIV) infection beyond the age of 9 years.
Methods:
This is a descriptive cohort study of 42 surviving perinatally infected children older than 9 years followed at the Children's Hospital Acquired Immunodeficiency Syndrome (AIDS) Program (part of a university-based inner city medical center) as of June 1993. The study is based on medical record data of clinical, immunologic, and psychosocial parameters.
Results:
The cohort includes 20 boys and 22 girls with a mean age of 136 months. The mean age at diagnosis of HIV infection was 88 months, and 59.5% were asymptomatic at the time of diagnosis. Currently, after a mean follow-up period of 48 months from diagnosis, 23.8% remain asymptomatic, 19.1% have non-AIDS-defining HIV-related symptoms, and 57.1% have AIDS; 85.7% of the cohort did not develop HIV-related symptoms until after 48 months of age (late-onset prolonged survivors). There was an average annual decline of 71.4 CD4+ cells/microL in the cohort from the ages of 7 to 16 years, and 21.4% have a current CD4+ lymphocyte count of greater than 500 cells/microL, 28.6% between 200 and 500 cells/microL, and 50% less than 200 cells/microL; 76% are orphaned as a result of maternal death, with the majority of the cohort (60%) cared for by extended family members. Disclosure of diagnosis has occurred in 57.1%. The vast majority of the cohort (76%) are attending regular school, with the remainder in special education.
Conclusions:
Although close to one quarter of the children and adolescents ages 9 to 16 years living with perinatally acquired HIV infection described in this cohort remain asymptomatic and have a relatively intact immune system, the remainder are living with significant HIV-related symptoms, many of which are chronic in nature and have an impact on daily living. The children in this cohort had both significant immunologic deterioration and symptomatic disease progression during the mean follow-up period of 48 months from the time of diagnosis with HIV infection.