Related Experiment Videos
Disease patterns and survival after acquired immunodeficiency syndrome diagnosis in human immunodeficiency
C R Morris1, L Araba-Owoyele, S A Spector
1Office of AIDS, California Department of Health Services, Sacramento 95814, USA.
Insights
Pediatric HIV infection survival was studied in 126 children. Antiviral therapies like Zidovudine improved survival, while respiratory candidiasis and wasting syndrome negatively impacted it.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Epidemiology
- HIV/AIDS Research
Background:
- Pediatric Human Immunodeficiency Virus (HIV) infection presents a wide range of clinical conditions, from mild symptoms to Acquired Immunodeficiency Syndrome (AIDS).
- Understanding disease progression and survival patterns in children with HIV is crucial for future healthcare planning and evaluating new treatments.
- Establishing baseline data is essential for assessing the efficacy of novel prophylactic and therapeutic interventions for pediatric HIV.
Purpose of the Study:
- To identify Acquired Immunodeficiency Syndrome (AIDS)-defining conditions in children with HIV.
- To estimate the survival duration after an AIDS diagnosis among HIV-infected children.
Main Methods:
- A cohort of 126 children with HIV infection was studied using data from a multisite university-based surveillance system in California (1989-1993).
- Disease patterns and survival post-AIDS diagnosis were analyzed through periodic review of hospital medical records.
- Kaplan-Meier and Cox proportional hazards regression models were employed to evaluate survival and the impact of disease patterns.
Main Results:
- The median age at diagnosis was 13 months for perinatally acquired HIV and 101.5 months for other transmission routes.
- Common AIDS-defining conditions in perinatal cases included Pneumocystis carinii pneumonia and lymphoid interstitial pneumonia; nonperinatal cases showed more varied patterns.
- The median survival time after an AIDS diagnosis for the entire cohort was 26 months.
Conclusions:
- Survival duration was not significantly influenced by race/ethnicity, sex, or transmission route.
- Respiratory candidiasis and wasting syndrome were linked to significantly poorer survival outcomes.
- Treatment with Zidovudine or other antiviral therapies was associated with enhanced survival in this pediatric cohort.
Background:
The clinical manifestations of HIV infection in children involve a broad spectrum of conditions ranging from mild symptoms to AIDS. Knowledge of the disease and survival patterns of these children are needed to plan for future needs and develop baseline information to evaluate newer prophylactic or therapeutic management options.
Objectives:
To identify AIDS-defining conditions and estimate post-AIDS diagnosis survival among HIV-infected children.
Methods:
Disease patterns and survival after the diagnosis of AIDS-defining conditions were studied in 126 children who were identified through a multisite university-based active surveillance system in California from January, 1989, through August, 1993. Hospital medical records were periodically reviewed and data were abstracted onto standardized forms designed for pediatric HIV surveillance. We determined the length of survival between AIDS diagnosis and death and evaluated the impact of disease patterns on survival using Kaplan-Meier's product-limit method and Cox proportional hazards regression.
Results:
The median age at diagnosis was 13 months for children with perinatally acquired infection and 101.5 months for children infected through other routes of transmission. Pneumocystis carinii pneumonia and lymphoid interstitial pneumonia were the most common AIDS-defining conditions among perinatal cases, whereas the disease patterns observed among nonperinatal cases were more varied. The median postdiagnosis survival for the cohort was 26 months.
Conclusions:
Survival time did not differ significantly by race/ethnicity, sex or route of transmission. Respiratory candidiasis and wasting syndrome had significant negative impact on survival but P. carinii pneumonia was not associated with shorter survival. Zidovudine or other antiviral therapies was associated with increased survival.