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Pediatric human immunodeficiency virus infection
1Pediatric Infectious Disease, State University of New York Health Science Center, Syracuse 13210, USA. jdomach@helix.nih.gov
Insights
Improving the identification of pregnant women with human immunodeficiency virus (HIV) is crucial for reducing vertical transmission. Early therapy for mothers and infants significantly impacts childhood HIV infection rates and outcomes.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of HIV/AIDS
- Maternal-child health
Background:
- Pediatric human immunodeficiency virus (HIV) infection significantly increases childhood morbidity and mortality globally.
- Vertical transmission from mother to infant is the primary route of pediatric HIV infection.
- Improved identification of infected pregnant women is essential for timely intervention.
Purpose of the Study:
- To review the epidemiology, diagnosis, natural history, and clinical manifestations of vertically transmitted HIV infection in children.
- To provide an overview of the medical management, including antiretroviral therapy and opportunistic infection prophylaxis.
Main Methods:
- Comprehensive literature review focusing on vertically transmitted HIV infection in pediatric populations.
- Analysis of epidemiological data, diagnostic criteria, and clinical outcomes.
- Synthesis of current management strategies, including antiretroviral and supportive therapies.
Main Results:
- While zidovudine treatment during pregnancy has shown success in reducing transmission in some groups, further reduction strategies are necessary.
- Vertically transmitted HIV presents with diverse infectious and noninfectious complications.
- Effective management involves complex antiretroviral therapy and opportunistic infection prophylaxis.
Conclusions:
- Reducing mother-to-child HIV transmission requires enhanced screening and timely initiation of therapy.
- Comprehensive, multidisciplinary care is vital for managing children with vertically acquired HIV.
- Ongoing research and improved interventions are critical to combatting the global impact of pediatric HIV.
Abstract:
In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies.