Prognostic factors and survival in children with perinatal HIV-1 infection

Tovo, Pier-Angelo; Gabiano, Clara; Palomba, E; Martino, Maurizio de; Galli, Luisa; Cappello, N.; D'Elia, R; Ruga, Ezia; Loy, Anna; Plebani, A; Zuccotti, Gian Vincenzo; Dallacasa, P; Ferraris, G; Caselli, Desireé; Fundarò, C.; D’Argenio, Patrizia; Principi, Nicola; Stegagno, M

doi:10.1016/0140-6736(92)91592-v

Cited by 314 publications

(60 citation statements)

References 20 publications

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“…The age distribution of long-term survivors was skewed toward the younger age group (8 years) among perinatally HIV-infected children which is in accordance with reports on the natural history of HIV infection 1,5,6 and also the timing of the pediatric epidemic (historically HIV acquired via blood transfusion occurred earlier in the AIDS epidemic whereas the perinatally acquired HIV epidemic peaked years later). The cohort surveyed only included living children and not children who might have died before or after 8 years because this survey was conducted in anticipation of future long-term survivor studies.…”

Section: Discussionsupporting

confidence: 73%

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

Nielsen

McSherry

Petru³

et al. 1997

Pediatrics

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ABSTRACT. Objective. To identify the population of human immunodeficiency virus-infected pediatric longterm 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 3 (group 1: mean age 9.8 years), 54 children (27%) had CD4 counts between 200 and 500 cells/mm 3 (group 2: mean age 10.1 years), and 89 children (45%) had CD4 counts <200 cells/mm 3 (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 3 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. Pediatrics 1997;99(4). URL: http: //www.pediatrics.org/cgi/content/full/99/4/e4; HIV, pediatric long-term survivors, slow disease progression.

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Section: Discussionsupporting

confidence: 73%

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

Nielsen

McSherry

Petru³

et al. 1997

Pediatrics

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“…Congenital transmission of T. gondii from pregnant women coinfected with T. gondii and HIV has been recognized as a unique problem [496][497][498][499][500][501][502][503] but fortunately a relatively uncommon one [504][505][506][507][508][509][510]. Documentation of previous infection before conception and the absence of demonstrable IgM antibodies to T. gondii in many of these women suggests that transmission in HIV-infected women can occur in the context of chronic infection.…”

Section: Congenital Toxoplasma Infection and Acquired Immunodeficiencmentioning

confidence: 99%

Toxoplasmosis

Remington¹,

McLeod²,

Wilson³

et al. 2011

Infectious Diseases of the Fetus and Newborn

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“…In infants with AIDS, encephalopathy, bacterial infections, and a unique type of lymphocytic pneumonia occur more frequently than in adults (2)(3)(4). Most infected infants become symptomatic within the first few months of life, however, a subset of infants remains asymptomatic with immune abnormalities for years (2)(3)(4).…”

mentioning

confidence: 99%

“…H IV disease in neonates and infants has a more rapid and fatal course than seen in infected adults (1,2). In infants with AIDS, encephalopathy, bacterial infections, and a unique type of lymphocytic pneumonia occur more frequently than in adults (2)(3)(4).…”

mentioning

confidence: 99%

Differential HIV-1 replication in neonatal and adult blood mononuclear cells is influenced at the level of HIV-1 gene expression

Sundaravaradan

Saxena

Ramakrishnan

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

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The majority of HIV-1-infected neonates and infants have a higher level of viremia and develop AIDS more rapidly than infected adults, including differences seen in clinical manifestations. To determine the mechanisms of HIV-1 infection in neonates vs. adults, we compared the replication kinetics of HIV-1 in neonatal (cord) and adult blood T lymphocytes and monocyte-derived macrophages (MDM) from seven different donors. We found that HIV-1 replicated 3-fold better in cord blood T lymphocytes compared with adult blood T lymphocytes and 9-fold better in cord MDM than adult MDM. We also show that this differential HIV-1 replication did not depend on differences in cell proliferative capabilities, cell surface expression of CD4, CXCR4, and CCR5, or in the amount of PCR products of reverse transcription, DNA synthesis, and translocation of preintegration complex into the nucleus in cord and adult T lymphocytes and MDM. Furthermore, using a single-cycle replication competent HIV-1-NL4 -3-Env ؊ luciferase amphotropic virus, which measures HIV-1 transcriptional activity independent of receptor and coreceptor expression, we found there was a 3-fold increase of HIV-1 LTR-driven luciferase expression in cord T lymphocytes compared with adult T lymphocytes and 10-fold in cord MDM than in adult MDM. The HIV-1 LTR-driven luciferase expression correlated with HIV-1 LTR transcription, as measured by ribonuclease protection assay. These data suggest that the increased replication of HIV-1 in cord blood compared with adult blood mononuclear cells is regulated at the level of HIV-1 gene expression, resulting in a higher level of viremia and faster disease progression in neonates than adults.

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Prognostic factors and survival in children with perinatal HIV-1 infection

Cited by 314 publications

References 20 publications

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

A Descriptive Survey of Pediatric Human Immunodeficiency Virus–infected Long-term Survivors

Toxoplasmosis

Differential HIV-1 replication in neonatal and adult blood mononuclear cells is influenced at the level of HIV-1 gene expression

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