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A descriptive survey of pediatric human immunodeficiency virus-infected long-term survivors
K Nielsen1, G McSherry, A Petru
1Department of Pediatrics, UCLA School of Medicine, Los Angeles, California, USA.
Insights
This study identified human immunodeficiency virus-infected pediatric long-term survivors (LTS) in major US institutions. Many LTS showed varied disease progression, with higher CD4 counts inversely related to age.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- Human immunodeficiency virus (HIV) infection in children presents unique challenges for long-term management.
- Understanding the characteristics of pediatric long-term survivors (LTS) is crucial for optimizing care and treatment strategies.
Purpose of the Study:
- To characterize the population of HIV-infected pediatric LTS followed at major medical centers in California, Florida, and New Jersey.
- To analyze demographic, clinical, and laboratory data of these long-term survivors.
Main Methods:
- A cross-sectional survey was conducted, collecting data from investigators at major medical institutions.
- Data included demographic, clinical, and laboratory information for living patients aged 8 years or older with perinatal HIV infection.
Main Results:
- 143 perinatally infected and 54 neonatally transfused children were identified.
- CD4 counts varied: 27% had >/=500 cells/mm, 27% had 200-500 cells/mm, and 45% had <200 cells/mm.
- 48% developed AIDS-defining conditions; lymphoid interstitial pneumonia and recurrent bacterial infections were most common.
Conclusions:
- Pediatric HIV LTS exhibit diverse stages of disease progression.
- Higher CD4 counts were inversely associated with age in this cohort.
- Only 20% of pediatric LTS demonstrated minimal to no disease progression, highlighting ongoing disease activity.
Objective:
To identify the population of human immunodeficiency virus-infected pediatric long- term survivors (LTS) followed in major medical institutions in California, Florida and New Jersey.
Methods:
A cross-sectional survey was performed with data collection forms sent to all investigators. Demographic, clinical, and laboratory data were obtained on all living patients >/=8 years infected in the perinatal period with human immunodeficiency virus.
Results:
A total of 143 perinatally infected and 54 children infected by neonatal transfusion were identified. Fifty-four children (27%) had absolute CD4 counts >/=500 cells/mm (group 1: mean age 9.8 years), 54 children (27%) had CD4 counts between 200 and 500 cells/mm (group 2: mean age 10.1 years), and 89 children (45%) had CD4 counts <200 cells/mm (group 3: mean age 10.4 years). Ninety-five (48%) patients had developed AIDS defining conditions; 14 (26%) in group 1, 26 (48%) in group 2, and 55 (62%) in group 3. Ninety-two percent of patients had received antiretrovirals. Perinatally human immunodeficiency virus-infected children tended to be younger (mean age 9.8 years) than children infected via a blood transfusion (mean age 11 years). Generalized lymphadenopathy was the most prevalent clinical finding. Lymphoid interstitial pneumonia and recurrent bacterial infections were the most prevalent acquired immune deficiency syndrome-defining conditions. Twenty percent of LTS had CD4 counts >/=500 cells/mm and no immune deficiency syndrome-defining conditions.
Conclusions:
Pediatric LTS were in variable stages of disease progression. The proportion of children within each CD4 strata did not differ by mode of acquisition of infection. Increased CD4 counts were inversely proportional to age. Only 20% of pediatric LTS had minimal to no disease progression.
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