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Very late presentation of vertically transmitted HIV-1 infection
T Español1, M C Figueras, V Soriano
1Immunology Unit, C.S. Vall d'Hebrón, Barcelona, Spain.
Insights
This case study highlights a rare, late diagnosis of vertically transmitted Human Immunodeficiency Virus type 1 (HIV-1) infection in a 13-year-old boy. Early treatment with AZT improved symptoms and viral load, emphasizing the need for clinical awareness.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Immunology
Background:
- Vertical transmission of Human Immunodeficiency Virus type 1 (HIV-1) can lead to late-onset disease.
- Delayed diagnosis of pediatric HIV-1 infection can result in significant clinical complications.
Observation:
- A 13-year-old boy presented with moderately severe respiratory symptoms (1994 Pediatric HIV classification B2).
- No other risk factors for HIV-1 infection were identified in the patient.
- Virological replicative kinetics and viral phenotype were characterized at diagnosis.
Findings:
- Diagnosis confirmed vertically transmitted HIV-1 infection.
- Initiation of standard Zidovudine (AZT) therapy led to clinical improvement.
- Successful treatment resulted in negativization of plasma p24 Antigen and HIV RNA.
Implications:
- Highlights the possibility of very late presentations of vertically transmitted HIV-1.
- Emphasizes the need for clinician awareness to prevent diagnostic delays in pediatric HIV.
- Demonstrates the efficacy of early antiretroviral therapy in managing advanced pediatric HIV-1 infection.
Abstract:
We describe a 13-year-old boy with a very late presentation of vertically transmitted HIV-1 infection. The mother, an intravenous drug user before pregnancy, was diagnosed with AIDS in 1987 when the boy was 6 years old. HIV infection in her son was never suspected or investigated. No other risk factors for this infection can be attributed to the boy. On diagnosis of the infection the boy had moderately severe respiratory symptoms, as classified in category B2 of the 1994 paediatric HIV infection definition, and virological replicative kinetics and the phenotype have been determined. Standard AZT therapy has improved the clinical symptoms, with negativization of plasma p24 Ag and HIV RNA. Clinicians should be aware of this form of presentation of HIV-1 infection to avoid further delay of proper therapy.