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PEDIATRICS HIV

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https://www.readbyqxmd.com/read/29469724/oral-lesions-as-an-important-marker-for-hiv-progression
#1
Paulo Henrique Braz-Silva, Juliana Lucena Schussel, Karen López Ortega, Marina Gallottini
BACKGROUND: Oral hairy leukoplakia (OHL) is a benign lesion caused by Epstein-Barr virus (EBV) replication in the oral epithelium affecting the borders of the tongue. It is strongly associated with immunosuppression, especially in HIV+ adults but is uncommon in pediatric population. The aim of the study is to show the importance of the correct diagnosis of OHL and its influence on HIV treatment.We report two cases of HIV+ adolescent patients that presented with leukoplakic lesions on the border of the tongue, suggestive of OHL...
September 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29466967/a-pediatric-death-audit-in-a-large-referral-hospital-in-malawi
#2
Elizabeth Fitzgerald, Rachel Mlotha-Mitole, Emily J Ciccone, Alyssa E Tilly, Jennie M Montijo, Hans-Joerg Lang, Michelle Eckerle
BACKGROUND: Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%...
February 21, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29466385/adherence-to-antiretroviral-therapy-in-a-clinical-cohort-of-hiv-infected-children-in-east-africa
#3
Rachel C Vreeman, Samuel O Ayaya, Beverly S Musick, Constantin T Yiannoutsos, Craig R Cohen, Denis Nash, Deo Wabwire, Kara Wools-Kaloustian, Sarah E Wiehe
OBJECTIVE: To describe antiretroviral therapy (ART) adherence and associated factors for a large HIV-infected pediatric cohort followed by sites of the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) consortium. METHODS: This study utilized prospectively collected clinical data from HIV-infected children less than 13 years of age who initiated ART within 4 clinical care programs (with 26 clinical sites) in Kenya, Uganda, and Tanzania and were followed for up to 6 years...
2018: PloS One
https://www.readbyqxmd.com/read/29462179/patient-navigators-for-people-with-chronic-disease-a-systematic-review
#4
Kerry A McBrien, Noah Ivers, Lianne Barnieh, Jacob J Bailey, Diane L Lorenzetti, David Nicholas, Marcello Tonelli, Brenda Hemmelgarn, Richard Lewanczuk, Alun Edwards, Ted Braun, Braden Manns
BACKGROUND: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. OBJECTIVE: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017...
2018: PloS One
https://www.readbyqxmd.com/read/29458337/hiv-1-transmission-and-survival-according-to-feeding-options-in-infants-born-to-hiv-infected-women-in-yaound%C3%A3-cameroon
#5
Anne Esther Njom Nlend, Annie Carole Nga Motaze, Arsene Sandie, Joseph Fokam
BACKGROUND: Evidence of 24-months survival in the frame of prevention of mother-to-child transmission (PMTCT) cascade-care is scare from routine programs in sub-Saharan African (SSA) settings. Specifically, data on infant outcomes according to feeding options remain largely unknown by month-24, thus limiting its breath for public-health recommendations toward eliminating new pediatric HIV-1 infections and improving care. We sought to evaluate HIV-1 vertical transmission and infant survival rates according to feeding options...
February 19, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29455264/mortality-rate-and-predictors-in-children-under-15-years-old-who-acquired-hiv-from-mother-to-child-transmission-in-paraguay
#6
Gloria Aguilar, Angélica Espinosa Miranda, George W Rutherford, Sergio Munoz, Nancy Hills, Tania Samudio, Fernando Galeano, Anibal Kawabata, Carlos Miguel Rios González
We estimated mortality rate and predictors of death in children and adolescents who acquired HIV through mother-to-child transmission in Paraguay. In 2000-2014, we conducted a cohort study among children and adolescents aged < 15 years. We abstracted data from medical records and death certificates. We used the Cox proportional hazards model for the multivariable analysis of mortality predictors. A total of 302 subjects were included in the survey; 216 (71.5%) were younger than 5 years, 148 (51.0%) were male, and 214 (70...
February 17, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29447374/spectrum-of-pediatric-tuberculosis-in-a-tertiary-care-setting-in-south-india
#7
Betsy Rebecca, Anila Chacko, Valsan Verghese, Winsley Rose
Background: Pediatric tuberculosis (TB) is often underdiagnosed with poor estimate of its true burden. Availability of Xpert MTB/RIF assay enhances diagnostic capacity of pediatric TB. Methods: A 3-year retrospective review of hospital records was done for all children diagnosed with confirmed and unconfirmed TB. Comparison was made between intrathoracic, single-site extrathoracic and disseminated TB. Results: In total, 274 children had TB with 130 (47...
February 13, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29403002/effect-of-hiv-hcv-co-infection-on-the-protease-evolution-of-hiv-1b-a-pilot-study-in-a-pediatric-population
#8
Sara Domínguez-Rodríguez, Patricia Rojas, Carolina Fernández McPhee, Israel Pagán, María Luisa Navarro, José Tomás Ramos, África Holguín
This pilot study evaluates in pediatric patients the impact of HIV/HCV coinfection in the molecular evolution of the HIV-1 subtype B protease (HIV-1BPR). For this study, HIV-1B/HCV coinfected (15) and HIV-1B monoinfected (56) patients with available HIV-1B pol sequences were enrolled. Both groups of patients had comparable gender frequencies and average age, time of infection, antiretroviral treatment (ART) exposure and time under ART. Prevalence of drug resistance mutations (DRM), genetic diversity, number of synonymous (dS) and non-synonymous (dN) mutations per site and selection pressures (dN - dS) in the HIV-1BPR were estimated and compared between mono- and coinfected patients...
February 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29389912/high-levels-of-dual-class-drug-resistance-in-hiv-infected-children-failing-first-line-antiretroviral-therapy-in-southern-ethiopia
#9
Birkneh Tilahun Tadesse, Natalie N Kinloch, Bemuluyigza Baraki, Hope R Lapointe, Kyle D Cobarrubias, Mark A Brockman, Chanson J Brumme, Byron A Foster, Degu Jerene, Eyasu Makonnen, Eleni Aklillu, Zabrina L Brumme
Clinical monitoring of pediatric HIV treatment remains a major challenge in settings where drug resistance genotyping is not routinely available. As a result, our understanding of drug resistance, and its impact on subsequent therapeutic regimens available in these settings, remains limited. We investigate the prevalence and correlates of HIV-1 drug resistance among 94 participants of the Ethiopia Pediatric HIV Cohort failing first-line combination antiretroviral therapy (cART) using dried blood spot-based genotyping...
February 1, 2018: Viruses
https://www.readbyqxmd.com/read/29372615/pattern-of-inpatient-pediatric-cardiology-consultations-in-sub-saharan-africa
#10
Kriti Puri, Peter Kazembe, Treasure Mkaliainga, Msandeni Chiume, Antonio G Cabrera, Amy Sims Sanyahumbi
Malawi is one of the poorest nations in the world, ranked 151st among 195 countries by the World Bank, with an under-5-year mortality rate of 63 per 1000 live births. There are no previous studies describing the spectrum of inpatient pediatric cardiology consultations in sub-Saharan Africa. A descriptive cohort study was performed at Kamuzu Central Hospital (KCH), a tertiary care hospital in Lilongwe, Malawi. Demographic, anthropometric, and clinical information for all cardiology consults patients aged 0-18 years admitted to the children's wards over a period of 1 month was reviewed...
January 25, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29357899/pediatric-multi-drug-resistant-tuberculosis-and-hiv-co-infection-in-a-resource-limited-setting-a-case-report
#11
Christelle Géneviève Jouego, Valirie Ndip Agbor, Juergen Noeske, Ndo Akono Manuel, Leo Njock Ayuk
BACKGROUND: Tuberculosis remains a major cause of morbidity and mortality worldwide, especially in developing countries. The diagnosis and treatment of multi-drug resistant tuberculosis (MDR-TB) in children remain a major limitation in this setting, largely due to difficulties in isolating Mycobacterium tuberculosis from pediatric specimens, management with toxic second line drugs, and practically the inexistence of contact tracing. In 2016, the World Health Organization (WHO) recommended a standardized 9-month regimen for adults and children in zones which are highly endemic for the human immunodeficiency virus (HIV)...
January 22, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29356763/temporal-improvements-in-long-term-outcome-in-care-among-hiv-infected-children-enrolled-in-public-art-care-an-analysis-of-outcomes-from-2004-2012-in-zimbabwe
#12
A Tariro Makadzange, Leanne Dougherty, Rutendo Birri, Gillian Kupakuwana, Janneke van Dijk, Mutsa Bwakura Dangarembizi, Nomvuyo Mothobi, Benjamin Phelps, Bisola Ojikutu, Chiratidzo E Ndhlovu
INTRODUCTION: Increasing numbers of children are requiring long-term HIV care and antiretroviral treatment (ART) in public ART programs in Africa but temporal trends and long-term outcomes in care remain poorly understood. METHODS: We analyzed outcomes in a longitudinal cohort of infants (<2 years) and children (2-10 years) enrolling in a public tertiary ART center in Zimbabwe over an eight-year period (2004-2012). RESULTS: The clinic enrolled 1644 infants and children; the median age at enrollment was 39 months (IQR 14-79), with a median CD4% of 17...
January 18, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29341396/pediatrics-and-donor-derived-disease-transmission-the-us-optn-experience
#13
Michael Green, Shandie Covington, Sarah Taranto, Marian G Michaels, Cameron Wolfe, Daniel R Kaul
PDDTE are tracked by the OPTN Ad Hoc DTAC. Specific evaluation of potential transmissions from pediatric deceased donors or the impact of donor-derived disease transmissions to pediatric organ recipients has not been previously undertaken. PDDTE reported to the DTAC between 2008 and 2013 were reviewed, characterized as proven, probable, possible, IWDT, unlikely, or excluded for both the whole event and each individual recipient. Pediatric donors and recipients were defined as being 0-17 years of age. Analysis was undertaken to characterize potential disease transmission from pediatric donors to adult or pediatric recipients and also to evaluate potential transmission from all donors to pediatric recipients...
January 17, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29338730/factors-associated-with-hiv-positive-sero-status-among-exposed-infants-attending-care-at-health-facilities-a-cross-sectional-study-in-rural-uganda
#14
Methuselah Muhindo Kahungu, Julius Kiwanuka, Frank Kaharuza, Rhoda K Wanyenze
BACKGROUND: East and South Africa contributes 59% of all pediatric HIV infections globally. In Uganda, HIV prevalence among HIV exposed infants was estimated at 5.3% in 2014. Understanding the remaining bottlenecks to elimination of mother-to-child transmission (eMTCT) is critical to accelerating efforts towards eMTCT. This study determined factors associated with HIV positive sero-status among exposed infants attending mother-baby care clinics in rural Kasese so as to inform enhancement of interventions to further reduce MTCT...
January 16, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29324985/urine-tb-lipoarabinomannan-lam-predicts-mortality-in-hospitalized-hiv-infected-children
#15
Sylvia M LaCourse, Lisa M Cranmer, Irene N Njuguna, John Gatimu, Joshua Stern, Elizabeth Maleche-Obimbo, Judd L Walson, Dalton Wamalwa, Grace John-Stewart, Patricia Pavlinac
Despite diagnostic performance limitations, urine lipoarabinomannan (LAM) predicts death in HIV-infected adults with TB. Pediatric data are limited. Among 137 hospitalized HIV-infected children, mortality was 4.9-fold higher among LAM-positives (127 vs. 31/100 py, aHR 4.92 [95%CI 1.79-13.49]; p=0.002). LAM identifies HIV-infected children at risk for death potentially missed by respiratory sampling.
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29324811/scale-up-of-kenya-s-national-hiv-viral-load-program-findings-and-lessons-learned
#16
Matilu Mwau, Catherine Akinyi Syeunda, Maureen Adhiambo, Priska Bwana, Lucy Kithinji, Joy Mwende, Laura Oyiengo, Martin Sirengo, Caroline E Boeke
OBJECTIVES: Kenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought to assess program scale up using the national database and identify areas for systems strengthening. METHODS: Data from January 2012 to March 2016 were extracted from Kenya's national viral load database. Characteristics of 1,108,356 tests were assessed over time, including reason for testing, turnaround times, test results, treatment regimens, and socio-demographic information...
2018: PloS One
https://www.readbyqxmd.com/read/29323688/preventing-hiv-infection-what-pediatricians-should-know-about-hiv-pre-exposure-prophylaxis
#17
Sabrina Fernandez
I recently diagnosed my first adolescent patient with new-onset HIV. As a primary care pediatrician, these cases are rare. I cried with the shock of the initial diagnosis, just as the patient did when I told him. One of my first thoughts was how could I have served him better. He had been inconsistent with condom use, and had several partners. I had encouraged safe sex practices, told him to talk to his partners about pregnancy prevention, and screened for sexually transmitted disease nearly every time he came into my office...
January 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29323687/pediatric-endocrinology-lead-toxicity-in-sickle-cell-disease-and-hiv-pre-exposure-prophylaxis
#18
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
January 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29315112/what-is-new-in-perinatal-hiv-prevention
#19
Mary G Fowler, Patricia Flynn, Jim Aizire
PURPOSE OF REVIEW: The purpose of this review is to describe recent clinical trial, laboratory and observational findings that highlight both the progress that can be achieved in elimination of new pediatric infections in international clinical trial settings among HIV-infected breastfeeding women while also describing recent safety concerns related to currently used antiretroviral regimens. The article will also address the ongoing adherence challenges for HIV-infected mothers in taking their antiretroviral drugs...
February 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29313586/eosinophilic-ascites-rarest-presentation-of-a-rare-disease-eosinophilic-gastroenteritis
#20
Iqbal Bagasarawala, J K Maniar, Abizer Manked, Hozefa Runderawala
Eosinophilic gastroenteritis (EGE) is an uncommon disease of unknown etiology reported in both adult and pediatric age group. Here we report a case of a 46-year-old HIV positive female who presented to us with ascites and abdominal distension with peripheral eosinophilia and diagnosed as EGE.
September 2017: Journal of the Association of Physicians of India
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