Risk Factors for Opportunistic Illnesses in Children With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Therapy

Ylitalo, Nathalie; Brogly, Susan B.; Hughes, Michael D.; Nachman, Sharon; Dankner, Wayne M.; Dyke, Russell Van; Seage, George R.

doi:10.1001/archpedi.160.8.778

Cited by 45 publications

(46 citation statements)

References 35 publications

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“…No associations were found between survival time free of oral candidiasis and the gender or age of children living with HIV/AIDS. These results are in agreement with findings reported in a cohort of American children 33 .…”

Section: Discussionsupporting

confidence: 93%

“…Survival free of disease was closely linked to the degree of immunodepression, as risk increased with the exacerbation of immune system impairment. This association has been described in previous cohorts of children throughout the world 32,33,34 . However, researchers state that defenses against Candida may be compromised by HIV even before the drop in the levels of CD4+ T lymphocytes 35,36 , which may explain the appearance of thrush in individuals with HIV whose defense cell counts are within the range of normality.…”

Section: Discussionsupporting

confidence: 77%

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Factors associated with time free of oral candidiasis in children living with HIV/AIDS, São Paulo, Brazil

et al. 2013

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 77%

Factors associated with time free of oral candidiasis in children living with HIV/AIDS, São Paulo, Brazil

et al. 2013

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“…Children with opportunistic infection have lower CD4 values compared to others without opportunistic infections. 10,11 In the present study, tuberculosis was found to be the commonest opportunistic infection in 25% children (including all forms of TB) with low CD4 ratio ranging from 6-32%. Similar observation was noted by Merchant et al in 84 (29.4%) patients out of 285.…”

mentioning

confidence: 50%

A study on clinical profile of paediatric HIV infection in the age group of 18 months to 12 years and its correlation with CD4 count

Ramaswamy¹,

Thandavarayan²,

Thirumalaikumarasamy³

et al. 2017

Int J Contemp Pediatr

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Background: The aim of the study was to assess the clinical profile of pediatric HIV infection in the age group of 18 month to 12 years and to correlate the clinical features with their CD4 count.Methods: This descriptive study was conducted over a period of 1 year from October 2007 to October 2008 at Govt. Mohan Kumaramangalam Medical College Hospital, Salem and included 100 children (aged between 18 months-12 years) diagnosed HIV by using rapid antigen tests or ELISA. Demographic data, clinical manifestations correlating with CD4 count and nutritional status of the children were recorded in predesigned proforma and analysed.Results: 100 children were included (males-65 and females-35) in the study. 22 children were asymptomatic and 78 were symptomatic. Clinical symptoms like skin lesions in 29, oral lesions in 10, lymphadenopathy in 46 children were observed. The respiratory (13%), central nervous (12%) and haemotological systems (16%) were most commonly involved organs systems. Children in stage III and IV disease were into Grade I-IV PEM classification (for weight) and majority of stage I-IV children were in Grade II according to Mclaren’s classification (for height).Conclusions: Majority of children with HIV infection presented with various clinical manifestations, malnutrition and immunosuppression. Hence, early identification of the disease and proper management in children helps in improving the immunological status and thereby life span of the child.

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“…Moreover, although ART has changed the clinical course of HIV infection as mentioned above; severe drug toxicity, treatment failure, developmental delay and other unwanted outcomes are not uncommon (11)(12)(13)(14). Therefore, the objective of this study was to assess immunologic and clinical outcomes of HIV infected children on HAART in JUSH.…”

mentioning

confidence: 99%

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

Workneh¹,

Girma²,

Woldie³

2011

Ethiop J Health Sci

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BACKGROU D:The nature of human immunodeficiency virus infection in children has changed from an often fatal to a treatable chronic condition with highly active antiretroviral therapy. The outcome of the therapy depends on multiple factors such as non-adherence to treatment, selection of resistant viral strains, drug toxicity and socioeconomic factors. The objective of this study was to determine the immunologic and clinical outcomes of children who are on highly active antiretroviral therapy at the ART clinic, Jimma University Specialized Hospital. METHOD: A three -year's retrospective cohort analysis was conducted in July 2008 among children younger than 14 years of age getting highly active antiretroviral therapy in Jimma University Specialized Hospital. Data was collected using a pre-tested record review format and analyzed using SPSS for Windows version 16.0 and World Health Organization Anthro v2.0.2 software. RESULT: Fifty three (55.2%) of the 96 patients were female, the mean age at initiation of treatment was 6 ± 4.2 years and the mean follow-up period was 13.7 ± 8 months. By the time of the study, 69 (71.9 %) patients were still on follow-up, 7 (7.3%) had died, 13 (13.5%) were lost to follow-up and the remaining 7(7.3%) were transferred-out. Majority (93.8%) of them were at WHO stage 3&4 during initiation of treatment. Median Weight-for-age Z-score improved from 0.09 to 0.26 after 6 month of treatment. Immunologic treatment failure was seen in 11(11.5%) of the patients; 5 of them also manifested clinical treatment failure. Severe drug toxicity occurred in 5 (5.2%) cases. Presence of chronic gastroenteritis, WHO clinical stage 4 at initiation and appearance of new opportunistic infection after starting treatment were associated with immunologic treatment failure (p <0.03). CO CLUSIO : Majority of the patients were having advanced clinical stage at initiation of treatment. Mortality rate and anthropometric changes of HIV infected children on highly active antiretroviral therapy were similar but immunologic treatment failure, loss to follow-up and severe drug toxicity were higher in this study compared to other reports from developing countries. Therefor, early diagnosis and treatment of HIV/AIDS and treatment monitoring should be strengthened.

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Risk Factors for Opportunistic Illnesses in Children With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Therapy

Cited by 45 publications

References 35 publications

Factors associated with time free of oral candidiasis in children living with HIV/AIDS, São Paulo, Brazil

Factors associated with time free of oral candidiasis in children living with HIV/AIDS, São Paulo, Brazil

A study on clinical profile of paediatric HIV infection in the age group of 18 months to 12 years and its correlation with CD4 count

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

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