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[AIDS in childhood]

F Bellini1, A Plebani, P Barbaccia

  • 1Servizio di Radiologia, Università di Milano.

La Radiologia Medica
|May 1, 1994
PubMed
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Pediatric HIV infection can lead to respiratory and neurological complications. Imaging studies reveal characteristic changes in infants, aiding in diagnosis and management of these opportunistic infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Diagnostic Imaging
  • Neonatal Care

Background:

  • Vertical transmission of Human Immunodeficiency Virus (HIV) in infants necessitates early diagnosis and monitoring.
  • Antibody levels in infants decrease over time, requiring clear criteria for infection status beyond 18 months.
  • Understanding the clinical and imaging manifestations of HIV in infants is crucial for timely intervention.

Purpose of the Study:

  • To analyze the clinical and diagnostic imaging findings in a cohort of 209 Human Immunodeficiency Virus (HIV)-positive infants.
  • To assess the evolution of changes detected through chest X-rays, brain, and abdomen ultrasounds (US).
  • To correlate imaging findings with clinical and laboratory data for improved diagnostic accuracy.

Main Methods:

Related Experiment Videos

  • Follow-up of 209 babies born to HIV-positive mothers.
  • Clinical and laboratory assessments.
  • Diagnostic imaging including chest films, brain and abdomen US, and CT scans.

    • Main Results:

    • Infants are susceptible to bacterial, viral, and protozoal infections, frequently affecting the respiratory system with conditions like dilatative cardiomyopathy.
    • Radiological patterns for bacterial infections show opacities with blurred, irregular, and confluent features.
    • Viral and protozoal infections present with linear fan-like opacities, small shadow areas, or enlarged hila; some cases show lung hyperexpansion without opacities.
    • Brain and abdomen US revealed no significant changes in newborns, but later US and CT showed hydrocephalic, atrophic, and hemorrhagic changes.
    • Common lung infections include Pneumocystis and Cytomegalovirus, presenting as diffuse, blurred, or cotton-like opacities.
    • Chronic interstitial lymphocyte pneumonia was observed with punctiform images.
    • Tuberculosis was rare, with only one case of active primary complex.
    • Candida infections and uncommon hepatopancreatic/lymph node changes were noted.

    Conclusions:

    • Early life HIV infection in infants predisposes them to severe bacterial and opportunistic infections, particularly affecting the respiratory system.
    • Diagnostic imaging, including chest X-rays and US, plays a vital role in identifying characteristic changes and monitoring disease progression in HIV-infected infants.
    • Neurological complications such as hydrocephalus and brain atrophy can develop in HIV-infected infants, detectable through imaging.