Disease Progression in a Cohort of Infants With Vertically Acquired HIV Infection Observed From Birth: The Women and Infants Transmission Study (WITS)

Díaz, Clemente; Hanson, Celine; Cooper, Ellen; Read, Jennifer S.; Watson, Jessica; Mendez, Hermann; Pitt, Jane; Rich, Kenneth; Smeriglio, Vincent L.; Lew, Judy

doi:10.1097/00042560-199807010-00004

Cited by 63 publications

(18 citation statements)

References 28 publications

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“…This population of children is known to progress more rapidly to AIDS, with strong evidence of efficacy of early treatment [4,8,34], which indicates the need for earlier interventions for the treatment of HIV infection. Based on this evidence, since 2009 Brazil has adopted measures on their therapeutic guidelines recommending the treatment of all HIV infected children < 1 year of age regardless of clinical symptoms, immunological classification or HIV viral load [35].…”

Section: Discussionmentioning

confidence: 99%

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Ramos

Matida²,

Hearst

et al. 2011

AIDS Res Ther

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BackgroundHAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil.MethodsThis study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed.ResultsIn total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001).ConclusionsDespite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.

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Section: Discussionmentioning

confidence: 99%

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Ramos

Matida²,

Hearst

et al. 2011

AIDS Res Ther

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“…The analysis revealed that children under the age of 12 months are 1.7 times more likely to be subject to late-stage diagnosis and had higher rates of disease progression and mortality com- pared with older children 5,27,28,29 , even in children with high CD4 cell counts 30 . Considering this high risk, all children in this age group should receive ART, regardless of clinical conditions, CD4 counts, or viral load 31 .…”

Section: Discussionmentioning

confidence: 99%

Late-stage diagnosis of HIV infection in Brazilian children: evidence from two national cohort studies

Ramos¹,

Matida²,

Alencar³

et al. 2013

Cad. Saúde Pública

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“…Hepatomegaly, hepatosplenomegaly and splenomegaly were placed in stage 2 rather than stage 1 as their presence has been associated with more rapid progression. 19,20 Stages 3 and 4 include conditions seen with progressive disease, stage 4 being more serious and more likely to result in early death. Pulmonary tuberculosis is in stage 3.…”

Section: World Health Organization Classificationmentioning

confidence: 99%

Classification of HIV disese in children - towards pragmatism?

Cotton

2005

South. Afr. j. HIV med.

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Disease Progression in a Cohort of Infants With Vertically Acquired HIV Infection Observed From Birth: The Women and Infants Transmission Study (WITS)

Cited by 63 publications

References 28 publications

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Late-stage diagnosis of HIV infection in Brazilian children: evidence from two national cohort studies

Classification of HIV disese in children - towards pragmatism?

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