Effect of continuous intravenous infusion of zidovudine (AZT) in children with symptomatic HIV infection

Pizzo, P A; Eddy, J B; Falloon, Judith; Balis, Frank M.; Rf, Murphy; Moss, Howard A.; Wolters, Pamela L.; Brouwers, Pim; Jarosinski, Paul; Rubin, Marc; Broder, Samuel; Yarchoan, Robert; Brunetti, Arturo; Maha, Mary; Nusinoff-Lehrman, Sandra; Dg, Poplack

doi:10.1016/0020-7292(89)90638-3

Cited by 68 publications

(88 citation statements)

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“…The prevalence of anemia in pediatric HIV ranges from 23% to 48% in high-income countries [24][25][26] to 78% to 90% in low-income countries. [27][28][29][30] In this study, we found that half of ARV-naive Asian children without advanced HIV had anemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

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Anemia is common in HIV-infected children and iron deficiency is thought to be a common cause. This study investigates the prevalence of anemia, thalassemia, and underlying iron status in Thai and Cambodian children without advanced HIV disease to determine the necessity of routine iron supplementation. Antiretroviral (ARV)-naive HIV-infected Asian children aged 1-12 years, with CD4 15-24%, CDC A or B, and hemoglobin (Hb) ‡ 7.5 g/dl were eligible for the study. Iron studies, serum ferritin, Hb typing, and C-reactive protein were assessed. Anemia was defined as Hb < 11.0 g/dl in children < 5 years of age or < 11.5 g/dl in children 5-12 years. We enrolled 299 children; 57.9% were female and the mean (SD) age was 6.3 (2.9) years. The mean (SD) CD4% and HIV-RNA were 20% (4.6) and 4.6 (0.6) log 10 copies/ml, respectively. The mean (SD) Hb and serum ferritin were 11.2 (1.1) g/dl and 78.3 (76.4) lg/liter, respectively. The overall iron deficiency anemia (IDA) prevalence was 2.7%. One hundred and forty-eight (50%) children had anemia, mostly of a mild degree. Of these, 69 (46.6%) had the thalassemia trait, 62 (41.8%) had anemia of chronic disease (ACD), 9 (6.1%) had thalassemia diseases, 3 (2.0%) had iron deficiency anemia, and 5 (3.4%) had IDA and the thalassemia trait. The thalassemia trait was not associated with increased serum ferritin levels. Mild anemia is common in ARV-naïve Thai and Cambodian children without advanced HIV. However, IDA prevalence is low; with the majority of cases caused by ACD. A routine prescription of iron supplement in anemic HIV-infected children without laboratory confirmation of IDA should be discouraged, especially in regions with a high prevalence of thalassemia and low prevalence of IDA.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

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“…Neurological dysfunction is often the earliest sign of HIV infection in infants and young children (Pizzo, et al, 1988) and can manifest as cognitive, language and/or motor delays. In developing countries where access to HIV management is stringent, Progressive encephalopathy has two subtypes -subacute progressive or plateau (Civitello, 2003).…”

Section: Clinical Manifestations Of Hiv Encephalopathymentioning

confidence: 99%

“…Significant improvements in child nutritional and growth status have been made with the use of ART (Jaspan, et al, 2008;Eley, et al, 2006;Verweel, et al, 2002). Positive, but limited improvements in neurodevelopmental functioning have been reported in numerous studies, however, these improvements did not reverse the existing neurodevelopmental impairment (Lindsey, et al, 2007;Foster, et al, 2006;Coplan, et al, 1998;Raskino, et al, 1999;Pizzo, et al, 1988). Despite ART, neurodevelopmental impairments persist due to existing regions of the CNS having sustained injury at critical periods of brain development (Foster, et al, 2006;Willen, 2006), as well as the blood-brain barrier (BBB) effectively preventing adequate permeation of ART into the CNS to suppress viral replication (Letendre, et al, 2008;Miller, 2002).…”

Section: Antiretroviral Eramentioning

confidence: 99%

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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The aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age).The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.

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“…Intrinsic effects of HIV-l on the infant's CNS include microcephaly, diffuse gliosis, and basal ganglia mineralization (3). In addition, an intrinsic HIV-l-induced damage has been indirectly demonstrated by the successful treatment of various forms of dementia and neurologic symptoms with zidovudine (4)(5)(6). Moreover, HIV-infected children have altered cortisol secretion, probably associated with specific CNS damage (7).…”

mentioning

confidence: 99%

“…destruction-whether a result of direct cellular infection of HIV, secondarily produced and up-regulated cytotoxic cytokines, or co-infection with opportunistic pathogens-remain an area of active research. During early human brain development, HIV-1 may influence the differentiation processes of CD4 -neuroblasts and oligodendrocyte precursors, resulting in dysmyelination and gliosis (1)(2)(3)(4)(5)(6)(7).…”

mentioning

confidence: 99%