Streptococcus pneumoniae in human immunodeficiency virus type 1-infected children

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Immunology

Background:

• Systemic Streptococcus pneumoniae infections pose a significant health risk, particularly in immunocompromised populations.
• Human immunodeficiency virus type 1 (HIV-1) infection can impair immune function, potentially increasing susceptibility to bacterial infections.

Purpose of the Study:

• To characterize the incidence, clinical presentation, and outcomes of systemic Streptococcus pneumoniae disease in children with HIV-1 infection.
• To compare the characteristics of S. pneumoniae infections in HIV-1 infected children versus a general pediatric population.

Main Methods:

• Retrospective review of Microbiology Laboratory records at Bellevue Hospital Center from August 1, 1978, to July 31, 1993.
• Inclusion criteria: children under 18 years old with bacteremia or meningitis caused by S. pneumoniae.
• Comparison between HIV-1 infected children and children without known HIV-1 infection.

Main Results:

• 19 HIV-1 infected children experienced 31 episodes of systemic S. pneumoniae disease, compared to 113 children with 116 episodes in the general population.
• HIV-1 infected children had a significantly higher rate of multiple S. pneumoniae bacteremia episodes (P = 0.008).
• Clinical presentation and seasonal distribution of infections were similar between groups; most HIV-1 infected patients recovered without significant sequelae.

Conclusions:

• Children with HIV-1 infection are at increased risk for recurrent Streptococcus pneumoniae bacteremia.
• Despite increased recurrence, the clinical course and outcomes of systemic S. pneumoniae infections in HIV-1 infected children are comparable to those in the general pediatric population.
• This highlights the importance of continued surveillance and management of pneumococcal disease in pediatric HIV-1 cohorts.