Horizontal HIV transmission to children of HIV-uninfected mothers: A case series and review of the global literature

Myburgh, Dirkie; Rabie, Helena; Slogrove, Amy L.; Edson, Clair; Cotton, Mark F.; Dramowski, Angela

doi:10.1016/j.ijid.2020.06.081

Cited by 24 publications

(12 citation statements)

References 17 publications

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“…8,9 While a study from South Africa assessing horizontal transmission of HIV in patients with uninfected mother reported median age of presentation to be 79 months. 10 There is male predominance seen in HIV infection not only in our study where out of 94 cases 61(65%) were boys and 33(35%) were girls but other studies as well. In a study from Islamabad there were 63% boys and 37% girls while a study from Karachi showed almost the same results with 62% males and 38% females.…”

Section: Discussionsupporting

confidence: 57%

Epidemiology and clinical spectrum of pediatric patients with human immunodeficiency virus (HIV) infection: A 15 years’ experience

Haider

Bashir²,

Farooq³

et al. 2023

Pak J Med Sci

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Objective: To view the different patterns of presentation of HIV in pediatric population along with mode of transmission and associated co infections and co morbidities Methods: It was a retrospective study conducted at Pakistan Institute of Medical Sciences, Islamabad, in which we evaluated the records of pediatric patients diagnosed with HIV from 2005 to 2020. All the data like age, gender, area, presenting complaints, examination findings at the time of diagnosis, mode of transmission, co infection and co morbidities were recorded. Descriptive analysis was done to calculate frequencies and means of the variables. SPSS 20 was used for data analysis. Results: Ninety four participants were evaluated with male to female ratio as 1.8:1 and mean age of 5.2 years. Majority of patients (44%) were below 4 years. Fever (55%) was the most reported symptom followed by cough (39%), diarrhoea (29%), pallor (27%), shortness of breath (26%), weight loss (23%) and failure to thrive (22%). Co infection with TB was present in (16%). Eight (9%) patients were thalassaemic. Mother to child transmission (60%) was the commonest mode of transmission followed by blood transfusion (23%) and parenteral transmission (6%). Conclusion: In children HIV is more prevalent in males especially under 4 years with fever, cough, diarrhea and pallor being the common symptoms at presentation. Tuberculosis is the commonest co infection as we are endemic for TB and mother to child transmission is the commonest mode of transmission as there was no outbreak in our area. doi: https://doi.org/10.12669/pjms.39.3.6710 How to cite this: Bashir N, Haider N, Farooq A, Hussain M. Epidemiology and clinical spectrum of pediatric patients with human immunodeficiency virus (HIV) infection: A 15 years’ experience. Pak J Med Sci. 2023;39(3):820-824. doi: https://doi.org/10.12669/pjms.39.3.6710 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 57%

Epidemiology and clinical spectrum of pediatric patients with human immunodeficiency virus (HIV) infection: A 15 years’ experience

Haider

Bashir²,

Farooq³

et al. 2023

Pak J Med Sci

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“…Earlier studies described several outbreaks of hospital-acquired HIV-1 among children in Osh province in 2007 (Thorne et al, 2010) and 2011-2012 (Mansfeld et al, 2015), with the total number of over 300 reported cases. Although healthcare-associated HIV-1 infections in high-income countries are extremely low, risk of nosocomial HIV-1 infections in the resource-limited countries remains high (Ganczak and Barss, 2008;Myburgh et al, 2020). We also identified significant differences in the transmission modes between genders.…”

Section: Discussionmentioning

confidence: 67%

Characterization of HIV-1 Epidemic in Kyrgyzstan

Sivay

Zyryanova

et al. 2021

Front. Microbiol.

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Kyrgyzstan has one of the highest rates of HIV-1 spread in Central Asia. In this study, we used molecular–epidemiological approaches to examine the HIV-1 epidemic in Kyrgyzstan. Samples were obtained from HIV-positive individuals who visited HIV/AIDS clinics. Partial pol gene sequences were used to identify HIV-1 subtypes and drug resistance mutations (DRMs) and to perform phylogenetic analysis. Genetic diversity and history reconstruction of the major HIV-1 subtypes were explored using BEAST. This study includes an analysis of 555 HIV-positive individuals. The study population was equally represented by men and women aged 1–72 years. Heterosexual transmission was the most frequent, followed by nosocomial infection. Men were more likely to acquire HIV-1 during injection drug use and while getting clinical services, while women were more likely to be infected through sexual contacts (p < 0.01). Heterosexual transmission was the more prevalent among individuals 25–49 years old; individuals over 49 years old were more likely to be persons who inject drugs (PWID). The major HIV-1 variants were CRF02_AG, CRF63_02A, and sub-subtype A6. Major DRMs were detected in 26.9% of the study individuals; 62.2% of those had DRMs to at least two antiretroviral (ARV) drug classes. Phylogenetic analysis revealed a well-defined structure of CRF02_AG, indicating locally evolving sub-epidemics. The lack of well-defined phylogenetic structure was observed for sub-subtype A6. The estimated origin date of CRF02_AG was January 1997; CRF63_02A, April 2004; and A6, June 1995. A rapid evolutionary dynamic of CRF02_AG and A6 among Kyrgyz population since the mid-1990s was observed. We observed the high levels of HIV-1 genetic diversity and drug resistance in the study population. Complex patterns of HIV-1 phylogenetics in Kyrgyzstan were found. This study highlights the importance of molecular–epidemiological analysis for HIV-1 surveillance and treatment implementation to reduce new HIV-1 infections.

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“…An additional element for consideration in the classification of children as HUU with high certainty is exclusion of child HIV infection in this group. Although non-vertical transmission is rare, cases and localized outbreaks continue to be documented, and high certainty that a child is HUU, under the proposed definition, requires the exclusion of HIV infection in the child rather than assuming this based on absence of maternal HIV infection [28][29][30]. Direct confirmation of child HIV status also has relevance for longterm cohorts as children age into adolescence and early adulthood and may become increasingly at risk for horizontal HIV acquisition.…”

Section: In Utero Hiv Exposure Definitionsmentioning

confidence: 99%

Standardized Definitions of In Utero Human Immunodeficiency Virus and Antiretroviral Drug Exposure Among Children

Slogrove

Burmen

Davies

et al. 2021

Clinical Infectious Diseases

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In countries with high human immunodeficiency virus (HIV) prevalence, up to 30% of pregnant women are living with HIV, with fetal exposure to both HIV and antiretroviral therapy during pregnancy. In addition, pregnant women without HIV but at high risk of HIV acquisition are increasingly receiving HIV preexposure antiretroviral prophylaxis (PrEP). Investments are being made to establish and follow cohorts of children to evaluate the long-term effects of in utero HIV and antiretroviral exposure. Agreement on a key set of definitions for relevant exposures and outcomes is important both for interpreting individual study results and for comparisons across cohorts. Harmonized definitions of in utero HIV and antiretroviral drug (maternal treatment or PrEP) exposure will also facilitate improved classification of these exposures in future observational studies and clinical trials. The proposed definitions offer a uniform approach to facilitate the consistent description and estimation of effects of HIV and antiretroviral exposures on key child health outcomes.

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Horizontal HIV transmission to children of HIV-uninfected mothers: A case series and review of the global literature

Cited by 24 publications

References 17 publications

Epidemiology and clinical spectrum of pediatric patients with human immunodeficiency virus (HIV) infection: A 15 years’ experience

Epidemiology and clinical spectrum of pediatric patients with human immunodeficiency virus (HIV) infection: A 15 years’ experience

Characterization of HIV-1 Epidemic in Kyrgyzstan

Standardized Definitions of In Utero Human Immunodeficiency Virus and Antiretroviral Drug Exposure Among Children

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