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Pediatric HIV Infection

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https://www.readbyqxmd.com/read/29341396/pediatrics-and-donor-derived-disease-transmission-the-us-optn-experience
#1
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
#2
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
#3
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/29323688/preventing-hiv-infection-what-pediatricians-should-know-about-hiv-pre-exposure-prophylaxis
#4
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/29315112/what-is-new-in-perinatal-hiv-prevention
#5
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/29303843/cognition-emotional-health-and-immunological-markers-in-children-with-long-term-nonprogressive-hiv
#6
Robert Paul, Tanakorn Apornpong, Wasana Prasitsuebsai, Thanyawee Puthanakit, Vonthanak Saphonn, Linda Aurpibul, Pope Kosalaraksa, Suparat Kanjanavanit, Wicharn Luesomboon, Chaiwat Ngampiyaskul, Tulathip Suwanlerk, Kea Chettra, William T Shearer, Victor Valcour, Jintanat Ananworanich, Stephen Kerr
BACKGROUND: HIV-infected children with long-term nonprogressive disease (LTNPs) eventually convert to a progressive disease type, yet the extent to which these children experience the cognitive and emotional symptoms observed in typical progressive HIV (Progressors) is unknown. METHODS: Eighty-eight LTNPs, 53 Progressors, and 323 healthy controls completed annual assessments of cognitive and emotional health as part of a prospective study. The two HIV-infected groups and the healthy controls were matched on age and sex distribution at enrollment...
January 4, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29287090/immune-activation-despite-preserved-cd4-t-cells-in-perinatally-hiv-infected-children-and-adolescents
#7
Patricia Alvarez, Mussa Mwamzuka, Fatma Marshed, Adam Kravietz, Tiina Ilmet, Aabid Ahmed, William Borkowsky, Alka Khaitan
BACKGROUND: HIV disease progresses more rapidly in children than adults with mortality rates exceeding 50% by 2 years of age without antiretroviral therapy (ART) in sub-Saharan Africa. Recent World Health Organization (WHO) guidelines recommend universal treatment for all living persons with HIV, yet there is limited supporting evidence in pediatric populations. The objective of this study was to determine whether CD4 cell counts reflect immunological markers associated with disease progression in ART naïve perinatally-infected HIV+ children and adolescents and their response to ART...
2017: PloS One
https://www.readbyqxmd.com/read/29287088/higher-retention-and-viral-suppression-with-adolescent-focused-hiv-clinic-in-south-africa
#8
Brian C Zanoni, Thobekile Sibaya, Chelline Cairns, Sara Lammert, Jessica E Haberer
OBJECTIVE: To determine retention in care and virologic suppression among HIV-infected adolescents and young adults attending an adolescent-friendly clinic compared to those attending the standard pediatric clinic at the same site. DESIGN: Retrospective cohort analysis. SETTING: Government supported, hospital-based antiretroviral clinic in KwaZulu-Natal, South Africa. PARTICIPANTS: Two hundred forty-one perinatally HIV-infected adolescents and young adults aged 13 to 24 years attending an adolescent-friendly clinic or the standard pediatric clinic from April 2007 to November 2015...
2017: PloS One
https://www.readbyqxmd.com/read/29280769/disclosure-consent-opportunity-costs-and-inaccurate-risk-assessment-deter-pediatric-hiv-testing-a-mixed-methods-study
#9
Anjuli D Wagner, Gabrielle O'malley, Olivia Firdawsi, Cyrus Mugo, Irene N Njuguna, Elizabeth Maleche-Obimbo, Irene W Inwani, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
(250/250 words) BACKGROUND:: Prompt child HIV testing and treatment is critical; however, children are often not diagnosed until symptomatic. Understanding factors that influence pediatric HIV testing can inform strategies to increase testing. METHODS: A mixed-methods study was conducted at a tertiary hospital in Nairobi, Kenya. Three focus group discussions with health care workers (HCW) and 18 in-depth interviews with HIV-infected adults with children of unknown status were analyzed using thematic analysis...
December 22, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29280758/changes-in-insulin-sensitivity-over-time-and-associated-factors-in-hiv-infected-adolescents
#10
Mitchell E Geffner, Kunjal Patel, Denise L Jacobson, Julia Wu, Tracie L Miller, Rohan Hazra, Mariana Gerschenson, Tanvi Sharma, Margarita Silio, Jennifer Jao, Jody K Takemoto, Russell B Van Dyke, Linda A Dimeglio
OBJECTIVE: To compare prevalence of IR between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of IR in PHIV+, and evaluate glucose metabolism. DESIGN: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of IR among PHIV+ at risk for these outcomes. METHODS: The source population was adolescents from pediatric HIV clinics in the US and Puerto Rico participating in PHACS AMP, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents...
December 26, 2017: AIDS
https://www.readbyqxmd.com/read/29280425/characterization-of-invasive-salmonella-serogroup-c1-infections-in-mali
#11
Fabien J Fuche, Sunil Sen, Jennifer A Jones, Joseph Nkeze, Jasnehta Permala-Booth, Milagritos D Tapia, Samba O Sow, Boubou Tamboura, Aliou Touré, Uma Onwuchekwa, Mamadou Sylla, Karen L Kotloff, Sharon M Tennant
Nontyphoidal Salmonella (NTS) are the leading cause of foodborne infections worldwide and a major cause of bloodstream infections in infants and HIV-infected adults in sub-Saharan Africa (SSA). Salmonella Typhimurium (serogroup B) and Salmonella Enteritidis (serogroup D) are the most common serovars in this region. However, data describing rarer invasive NTS serovars, particularly those belonging to serogroups C1 and C2, circulating in SSA are lacking. We previously conducted systematic blood culture surveillance on pediatric patients in Bamako, Mali, from 2002 to 2014, and the results showed that serovars Typhimurium and Enteritidis accounted for 32% and 36% of isolates, respectively...
December 26, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29260263/systematic-literature-review-on-the-incidence-and-prevalence-of-heart-failure-in-children-and-adolescents
#12
REVIEW
Robert E Shaddy, Aneesh Thomas George, Thomas Jaecklin, Eimear Nic Lochlainn, Lalit Thakur, Rumjhum Agrawal, Susan Solar-Yohay, Fabian Chen, Joseph W Rossano, Thomas Severin, Michael Burch
While the epidemiology of adult heart failure has been extensively researched, this systematic review addresses the less well characterized incidence and prevalence of pediatric HF. The search strategy used Cochrane methodology and identified 83 unique studies for inclusion. Studies were categorized according to whether the HF diagnosis was reported as primary (n = 10); associated with other cardiovascular diseases (CVDs) (n = 49); or associated with non-CVDs (n = 24). A narrative synthesis of the evidence is presented...
December 20, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29259605/role-of-monocyte-macrophages-during-hiv-siv-infection-in-adult-and-pediatric-acquired-immune-deficiency-syndrome
#13
REVIEW
Kristen M Merino, Carolina Allers, Elizabeth S Didier, Marcelo J Kuroda
Monocytes/macrophages are a diverse group of cells that act as first responders in innate immunity and then as mediators for adaptive immunity to help clear infections. In performing these functions, however, the macrophage inflammatory responses can also contribute to pathogenesis. Various monocyte and tissue macrophage subsets have been associated with inflammatory disorders and tissue pathogeneses such as occur during HIV infection. Non-human primate research of simian immunodeficiency virus (SIV) has been invaluable in better understanding the pathogenesis of HIV infection...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29247506/suboptimal-anti-tuberculosis-drug-concentrations-and-outcomes-in-small-and-hiv-coinfected-children-in-india-recommendations-for-dose-modifications
#14
Benjamin Guiastrennec, Geetha Ramachandran, Mats O Karlsson, A K Hemanth Kumar, Perumal Kannabiran Bhavani, N Poorana Gangadevi, Soumya Swaminathan, Amita Gupta, Kelly E Dooley, Radojka M Savic
This work aimed to evaluate the once-daily anti-tuberculosis treatment as recommended by the new Indian pediatric guidelines. Isoniazid, rifampin and pyrazinamide concentration-time profiles and treatment outcome were obtained from 161 Indian children with drug-sensitive tuberculosis undergoing thrice-weekly dosing as per previous Indian pediatric guidelines. The exposure-response relationships were established using a population pharmacokinetic-pharmacodynamic approach. Rifampin exposure was identified as the unique predictor of treatment outcome...
December 16, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29237287/early-sites-of-virus-replication-after-oral-sivmac251-infection-of-infant-macaques-implications-for-pathogenesis
#15
Angela Amedee, Bonnie Phillips, Kara Jensen, Spencer Robichaux, Nedra Lacour, Mark Burke, Michael Piatak, Jeffrey Lifson, Pamela A Kozlowski, Koen K A Van Rompay, Kristina De Paris
Despite optimization of preventative measures for vertical HIV-1 transmission, daily roughly 400 infants become HIV infected, most of them via breastfeeding. Viral entry has been presumed to occur in the gastrointestinal tract; however, the exact entry site(s) have not been defined. Therefore, we quantified viral RNA and DNA in oral, intestinal and systemic tissues of 15 infant macaques within 48-96 hours after oral SIVmac251 exposure. SIV DNA was detected as early as 48 hours, whereas SIV RNA was typically detected at later time points (72-96 hours)...
December 14, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29227466/morbidity-and-mortality-of-a-cohort-of-peruvian-hiv-infected-children-2003-2012
#16
Amira N Baker, Angela M Bayer, Rolando M Viani, Lenka Kolevic, Myung-Shin Sim, Jaime G Deville
BACKGROUND: Data on pediatric HIV in Peru is limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under age 18 in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003-2012...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29227461/population-pharmacokinetics-of-lopinavir-in-severely-malnourished-hiv-infected-children-and-the-effect-on-treatment-outcomes
#17
Moherndran Archary, Helen Mcllleron, Raziya Bobat, Phillip La Russa, Thobekile Sibaya, Lubbe Wiesner, Stefanie Hennig
BACKGROUND: In developing countries, malnutrition remains a common clinical syndrome at antiretroviral treatment (ART) initiation. Physiological changes due to malnutrition and during nutritional recovery could affect the pharmacokinetics of antiretroviral drugs. METHODS: HIV-infected children admitted with severe acute malnutrition were randomised to early or delayed initiation of lopinavir/ritonavir, abacavir and lamivudine using WHO weight-band dosage charts...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29224754/prevalence-of-chronic-ear-disease-among-hiv-children-in-sub-saharan-africa
#18
David C Ianacone, Alden F Smith, Margaretha L Casselbrant, Robbert J H Ensink, Farrel Buchinsky, Abebe Melaku, Glenn Isaacson
OBJECTIVES: To determine the prevalence of chronic ear disease in HIV+, highly active anti-retroviral therapy (HAART)-treated children and compare this to the prevalence in healthy children of similar age living in a similar setting. INTRODUCTION: From previous clinical work in Ethiopia, we suspected that chronic middle ear disease was common both in the general pediatric population and especially among children with HIV/AIDS. Few studies have examined the prevalence of chronic ear disease in HIV + children, particularly in those treated with HAART...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29200184/structural-neuroimaging-and-neuropsychologic-signatures-of-vertically-acquired-hiv
#19
Robert Paul, Wasana Prasitsuebsai, Neda Jahanashad, Thanyawee Puthanakit, Paul Thompson, Linda Aurpibul, Rawiwan Hansudewechakul, Pope Kosalaraksa, Suparat Kanjanavanit, Chaiwat Ngampiyaskul, Wicharn Luesomboon, Sukalaya Lerdlum, Mantana Pothisri, Pannee Visrutaratna, Victor Valcour, Talia M Nir, Arvin Saremi, Stephen Kerr, Jintanat Ananworanich
BACKGROUND: Children with vertically acquired human immunodeficiency virus (HIV) exhibit persistent cognitive impairments, yet the corresponding neuroimaging signature of vertical infection remains unclear. METHODS: Fifty healthy control children and 51 vertically infected children were included in the study. The HIV-infected group consisted of survivors who had not received antiretroviral therapy (ART) at birth. The HIV-infected group averaged 11.4 (2.5) years of age, with a median CD4 count of 683 cells/mm...
December 1, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29190684/respiratory-syncytial-and-influenza-viruses-in-children-under-2-years-old-with-severe-acute-respiratory-infection-sari-in-maputo-2015
#20
Mirela Pale, Afonso Nacoto, Almiro Tivane, Neuza Nguenha, Loira Machalele, Félix Gundane, Délcio Muteto, Josina Chilundo, Sandra Mavale, Cynthia Semá-Baltazar, Germano Pires, Orvalho Augusto, Tufária Mussá, Eduardo Gudo
INTRODUCTION: Although respiratory syncytial virus (RSV) and influenza virus (influenza) infections are one of the leading causes of Severe Acute Respiratory Infections (SARI) and death in young children worldwide, little is known about the burden of these pathogens in Mozambique. MATERIAL AND METHODS: From January 2015 to January 2016, nasopharyngeal swabs from 450 children, aged ≤2 years, who had been admitted to the Pediatric Department of the Maputo Central Hospital (HCM) in Mozambique, suffering with SARI were enrolled and tested for influenza and RSV using a real-time PCR assay...
2017: PloS One
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