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Pediatric HIV Infection

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https://www.readbyqxmd.com/read/29141709/rapid-diagnostic-testing-of-hospitalized-malawian-children-reveals-opportunities-for-improved-hiv-diagnosis-and-treatment
#1
Theresa F Madaline, Sarah E Hochman, Karl B Seydel, Alice Liomba, Alex Saidi, Grace Matebule, Wenzhu B Mowrey, Bernadette O'Hare, Danny A Milner, Kami Kim
Recent World Health Organization (WHO) guidelines recommend antiretroviral therapy (ART) for all HIV-infected people; previously CD4+ T lymphocyte quantification (CD4 count) or clinical staging determined eligibility for children ≥ 5 years old in low- and middle-income countries. We examined positive predictive value (PPV) of a rapid diagnostic test (RDT) algorithm and ART eligibility for hospitalized children with newly diagnosed HIV infection. We enrolled 363 hospitalized Malawian children age 2 months to 16 years with two serial positive HIV RDT from 2013 to 2015...
October 16, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29140938/immunity-following-childhood-vaccinations-in-perinatally-hiv-exposed-children-with-and-without-hiv-infection-in-latin-america
#2
Regina Cm Succi, Margot R Krauss, D Robert Harris, Daisy M Machado, Maria I de Moraes-Pinto, Marisa M Mussi-Pinhata, Noris Pavia Ruz, Russell B Pierre, Lenka A Kolevic Roca, Esaú Joao, Irene Foradori, Marcelo C Scotta, Rohan Hazra, George K Siberry
BACKGROUND: Perinatally HIV-infected (PHIV) children are at risk for undervaccination and poor vaccine response at four years of age. Childhood vaccine coverage and immune response were compared between PHIV and HIV-exposed uninfected (HEU) children in Latin America and the Caribbean. METHODS: PHIV and HEU children were enrolled prospectively at fifteen sites from 2002-2009. Full vaccination by age four years was defined as: three hepatitis B virus (HBV) vaccine doses; four tetanus toxoid-containing vaccine doses; three doses of Haemophilus influenzae type b (Hib) vaccine by age 12 months or ≥1 dose given after age 12 months; one measles-containing vaccine dose; one rubella-containing vaccine dose...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140933/t-spot-tb%C3%A2-performance-in-routine-pediatric-practice-in-a-low-tb-burden-setting
#3
Anna M Mandalakas, Heather Y Highsmith, Nadine M Harris, Anna Pawlicka, H Lester Kirchner
BACKGROUND: The T-SPOT.TB, an interferon-γ release assay (IGRA), is an indirect test of Mycobacterium tuberculosis infection. Due to sparse and conflicting evidence, IGRA use is limited in young and HIV-infected children. We determined the prevalence of invalid, borderline, positive, and negative results and associations with key demographic variables during routine pediatric use in a TB low-burden setting. METHODS: For pediatric samples received at Oxford Diagnostic Laboratories from 2010-2015, the associations between initial test outcome and demographics were estimated by bivariate analysis and logistic regression...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140932/characteristics-of-treatment-experienced-hiv-infected-african-children-and-adolescents-initiating-darunavir-and-or-etravirine-based-antiretroviral-treatment
#4
Bethany Corrigan, Irene Mukui, Lloyd Mulenga, Nobuhle Mthethwa, Mosilinyane Letsie, Stephanie Bruno, Natella Rakhmanina
BACKGROUND: Data are limited on the selection and sequencing of second and third-line pediatric antiretroviral treatment (ART) in resource-limited settings. This study aimed to evaluate characteristics of African pediatric patients initiated on darunavir (DRV) and/or etravirine (ETR) through a specific drug donation program. METHODS: This was a cross-sectional study of baseline immunologic, virologic and demographic characteristics of children and adolescents initiating DRV- and/or ETR-based ART...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29138020/moyamoya-syndrome-in-a-pediatric-patient-with-congenital-human-immunodeficiency-virus-type-1-infection-resulting-in-intracranial-hemorrhage
#5
Junko Yamanaka, Ikuma Nozaki, Mizue Tanaka, Hideko Uryuu, Noriko Sato, Takeji Matsushita, Hiroyuki Shichino
In the era of Antiretroviral Therapy (ART) in which human immunodeficiency virus type 1 (HIV-1) infection affected children can expect a better prognosis, the importance of careful follow up of pediatric HIV-1 cases for neurological complications has been growing. We present a case of hemorrhagic Moyamoya syndrome in a child with congenital HIV-1 infection. A 10-year-old girl was referred to our hospital for the treatment of Pneumocystis Jirovecii Pneumonia (PCP: Pneumocystis pneumonia). Her HIV-1 control was poor and Moyamoya syndrome was found during the opportunistic infection screening at admission...
November 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29135578/when-prevention-of-mother-to-child-hiv-transmission-fails-preventing-pretreatment-drug-resistance-in-african-children
#6
Seth C Inzaule, Raph L Hamers, Job Calis, Ragna Boerma, Kim Sigaloff, Clement Zeh, Peter Mugyenyi, Sulaimon Akanmu, Tobias F Rinke de Wit
: The scale-up of antiretroviral prophylaxis to prevent mother-to-child transmission of HIV has significantly reduced new pediatric infections in sub-Saharan Africa. However, among infants who become HIV-infected despite prevent mother-to-child transmission, more than 50% have drug-resistant HIV. Given high levels of resistance, WHO recommends the use of protease inhibitors as part of first-line pediatric antiretroviral therapy (ART) to optimize treatment response, but costs and logistic challenges restrict access...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29111178/dose-dependent-neurocognitive-deficits-following-postnatal-day-10-hiv-1-viral-protein-exposure-relationship-to-hippocampal-anatomy-parameters
#7
Sylvia Fitting, Kristen A McLaurin, Rosemarie M Booze, Charles F Mactutus
Despite the availability of antiretroviral prophylactic treatment, pediatric human immunodeficiency virus type 1 (HIV-1) continues to be a significant risk factor in the post-cART era. The time of infection (i.e., during pregnancy, delivery or breastfeeding) may play a role in the development of neurocognitive deficits in pediatric HIV-1. HIV-1 viral protein exposure on postnatal day (P)1, preceding the postnatal brain growth spurt in rats, had deleterious effects on neurocognitive development and anatomical parameters of the hippocampus (Fitting et al...
October 27, 2017: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/29061870/sexual-and-reproductive-health-care-services-in-the-pediatric-setting
#8
REVIEW
Arik V Marcell, Gale R Burstein
Pediatricians are an important source of health care for adolescents and young adults and can play a significant role in addressing their patients' sexual and reproductive health needs, including preventing unintended pregnancies and sexually transmitted infections (STIs), including HIV, and promoting healthy relationships. STIs, HIV, and unintended pregnancy are all preventable health outcomes with potentially serious permanent sequelae; the highest rates of STIs, HIV, and unintended pregnancy are reported among adolescents and young adults...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29045697/impact-of-human-immunodeficiency-virus-drug-resistance-on-treatment-of-human-immunodeficiency-virus-infection-in-children-in-low-and-middle-income-countries
#9
George K Siberry, Anouk Amzel, Artur Ramos, Emilia D Rivadeneira
Children living with human immunodeficiency virus (HIV) in low- and middle-income countries (LMICs) experience higher rates of virologic failure than adults. Human immunodeficiency virus drug resistance (HIVDR) plays a major role in pediatric HIV treatment failure because nonsuppressive maternal antiretroviral therapy (ART) during pregnancy and breastfeeding as well as infant antiretroviral prophylaxis lead to high rates of pretreatment drug resistance to regimens most commonly used in children living with HIV...
October 17, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29044435/impact-of-clinical-parameters-in-the-intrahost-evolution-of-hiv-1-subtype-b-in-pediatric-patients-a-machine-learning-approach
#10
Patricia Rojas Sánchez, Alberto Cobos, Marisa Navaro, José Tomas Ramos, Israel Pagán, África Holguín
Determining the factors modulating the genetic diversity of HIV-1 populations is essential to understand viral evolution. This study analyzes the relative importance of clinical factors in the intrahost HIV-1 subtype B (HIV-1B) evolution and in the fixation of drug resistance mutations (DRM) during longitudinal pediatric HIV-1 infection. We recovered 162 partial HIV-1B pol sequences (from 3 to 24 per patient) from 24 perinatally infected patients from the Madrid Cohort of HIV-1 infected children and adolescents in a time interval ranging from 2...
October 1, 2017: Genome Biology and Evolution
https://www.readbyqxmd.com/read/29027480/a-learning-collaborative-approach-to-improve-primary-care-sti-screening
#11
M Diane McKee, Elizabeth Alderman, Deborah V York, Arthur E Blank, Rahil D Briggs, Kelsey E S Hoidal, Christopher Kus, Claudia Lechuga, Marie Mann, Paul Meissner, Nisha Patel, Andrew D Racine
The Bronx Ongoing Pediatric Screening (BOPS) project sought to improve screening for sexual activity and sexually transmitted infections (gonorrhea and chlamydia [GCC] and HIV) in a primary care network, employing a modified learning collaborative, real-time clinical data feedback to practices, improvement coaching, and a pay-for-quality monetary incentive. Outcomes are compared for 11 BOPS-participating sites and 10 non-participating sites. The quarterly median rate for documenting sexual activity status increased from 55% to 88% (BOPS sites) and from 13% to 74% (non-BOPS sites)...
October 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29023357/pharmacokinetics-safety-and-efficacy-of-maraviroc-in-treatment-experienced-pediatric-patients-infected-with-ccr5-tropic-hiv-1
#12
Carlo Giaquinto, Muthuhadini Patience Mawela, Kulkanya Chokephaibulkit, Marinella Della Negra, Ismail Haroon Mitha, Jan Fourie, Annie Fang, Elna van der Ryst, Srinivas Rao Valluri, Manoli Vourvahis, Rebecca Yanhui Zhang-Roper, Charles Craig, Lynn McFadyen, Andrew Clark, Jayvant Heera
BACKGROUND: Maraviroc is a CCR5 antagonist approved to treat adults infected with CCR5-tropic (R5) HIV-1. Study A4001031 was conducted to evaluate the pharmacokinetics, safety, and efficacy of maraviroc in combination with optimized background therapy (OBT) in treatment-experienced pediatric patients infected with R5 HIV-1 and support registration of maraviroc for pediatric use. METHODS: This is an open-label, 2-stage, age-stratified, non-comparative multicenter study...
October 7, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29023355/utility-of-mobile-communication-devices-as-a-tool-to-improve-adherence-to-antiretroviral-treatment-in-hiv-infected-children-and-young-adults-in-argentina
#13
Erica Stankievich, Adriana Malanca, Irene Foradori, Silvina Ivalo, Marcelo Losso
BACKGROUND: Optimal adherence is critical to achieve the benefits of antiretroviral treatment (ART). The aim of the study is to evaluate the use of mobile devices as a strategy to improve adherence to ART, measured by Viral Load (VL) in HIV+ patients less than 25 years of age. METHODS: A prospective study was conducted in a cohort of HIV+ patients less than 25 years of age. HIV+ patients, on ART, VL >1000 copies/mL, using mobile devices and suboptimal adherence (SOA) were included...
October 7, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29021661/successful-renal-transplant-in-a-pediatric-patient-with-hiv-associated-nephropathy
#14
Anshuman Sood, David Hakim, Abhishek Bose
HIV-associated nephropathy (HIVAN) is a pathological state of the kidneys due to longstanding, uncontrolled HIV infection. With the rapid progression of HIVAN to end-stage kidney failure, there is a significant potential for renal transplantation to improve the quality of life in these patients. Numerous studies have been recently published documenting renal transplantation as a primary treatment for HIVAN. With the use of highly active antiretroviral therapy, allograft and patient survival rates of HIV-infected persons are nearly identical to those who are HIV negative...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29021402/hiv-exposed-infants-vaccinated-with-a-mf59-rgp120-vaccine-have-higher-magnitude-anti-v1v2-igg-responses-than-adults-immunized-with-the-same-vaccine
#15
Erin P McGuire, Youyi Fong, Christopher Toote, Coleen K Cunningham, Elizabeth J McFarland, William Borkowsky, Susan Barnett, Hannah L Itell, Amit Kumar, Glenda Gray, M Julianna McElrath, Georgia D Tomaras, Sallie R Permar, Genevieve G Fouda
In the RV144 vaccine trial, IgG responses against the HIV envelope variable loops 1 and 2 (V1V2) were associated with decreased HIV acquisition risk. We previously reported that infants immunized with a MF59 adjuvanted rgp120 vaccine developed higher magnitude anti-V1V2 IgG responses than adult RV144 vaccinees. To determine if the robust antibody response in infants is due to differences in vaccine regimens or to inherent differences between the adult and infant immune systems, we compared Env-specific IgG responses in adults and infants immunized with the same MF59 and Alum adjuvanted HIV envelope vaccines...
October 11, 2017: Journal of Virology
https://www.readbyqxmd.com/read/29020335/hiv-drug-resistance-in-african-infants-and-young-children-newly-diagnosed-with-hiv-a-multicounty-analysis
#16
Michael R Jordan, Martina Penazzato, Amandine Cournil, Adolfo Vubil, Ilesh Jani, Gillian Hunt, Sergio Carmona, Gugu Maphalala, Nobuhle Mthethwa, Christine Watera, Pontiano Kaleebu, Christine Chakanyuka Musanhu, Sekesai Mtapuri-Zinyowera, Janet Dzangare, Martine Peeters, Chunfu Yang, Neil Parkin, Silvia Bertagnolio
Background: Prevention of mother-to-child transmission (PMTCT) of HIV programs have been scaled-up in many low- and middle-income countries; however, HIV drug resistance (HIVDR) data amongst HIV-1-infected young children remain limited. Methods: Surveys of pre-treatment HIVDR amongst children younger than 18 months of age who were diagnosed with HIV through Early Infant Diagnosis were conducted in five sub-Saharan African countries (Mozambique, Swaziland, South Africa, Uganda, and Zimbabwe) between 2011 and 2014 following World Health Organization guidance...
August 8, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28991889/trends-in-drug-resistance-prevalence-hiv-1-variants-and-clinical-status-in-hiv-1-infected-pediatric-population-in-madrid-1993-2015-analysis
#17
Patricia Rojas Sánchez, Sara Domínguez, Santiago Jiménez De Ory, Luis Prieto, Pablo Rojo, Pepa Mellado, Marisa Navarro, Rafael Delgado, José Tomas Ramos, África Holguín
BACKGROUND: The expanded use of long-term antiretroviral treatments in infected children may exacerbate the problem of drug resistance mutations (HIVDR) selection, which can compromise treatment efficiency. OBJECTIVE: We describe the temporal trends of HIVDR and the HIV-1 variants during 23 years (1993-March 2016) in the Madrid cohort of HIV-infected children and adolescents. METHODS: We selected patients with at least one available HIV-1 pol sequence/genotypic resistance profile, establishing different groups according to the sampling year of first resistance data...
October 6, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28991881/scaling-up-pediatric-hiv-testing-by-incorporating-provider-initiated-hiv-testing-into-all-child-health-services-in-hurungwe-district-zimbabwe
#18
Reuben Musarandega, Blessing Mutede, Agnes Mahomva, Wenceslas Nyamayaro, Angela Mushavi, Christina Lindan, Rhoderick Machekano
BACKGROUND: Practical ways are needed to scale-up pediatric HIV testing in sub-Saharan Africa, where testing is usually limited to HIV-exposed children in maternal and child health clinics. METHODS: We implemented an enhanced pediatric HIV testing program in 33 health facilities in Zimbabwe by integrating HIV testing into all pediatric health services. We collected individual data on children tested by having healthcare workers complete a program-specific child health booklet...
October 4, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28987830/intracranial-meningioma-in-patients-younger-than-35-years-of-age-an-evolution-of-the-disease-in-the-era-of-human-immunodeficiency-virus-infection-a-retrospective-observational-study
#19
Mogwale Samson Motebejane, Ian Kaminsky, In Sup Choi
BACKGROUND: Intracranial meningiomas are more common among patients in their 5(th)-7(th) decades of life and rare in children and early adulthood. They constitute between 1.5% of all neoplasms in patients younger than 20 years of age but account for 13.5% of all neoplasms in patients aged between 20-34 years. They are often associated with hereditary or familial syndromes in pediatrics and young adults and tend to be of high grade. OBJECTIVES: We describe the histopathological subtypes of intracranial meningioma between HIV seropositive and the general patients population with intracranial meningiomas, younger than 35 years of age...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28983013/role-of-hiv-specific-cd8-t-cells-in-pediatric-hiv-cure-strategies-after-widespread-early-viral-escape
#20
Ellen M Leitman, Christina F Thobakgale, Emily Adland, M Azim Ansari, Jayna Raghwani, Andrew J Prendergast, Gareth Tudor-Williams, Photini Kiepiela, Joris Hemelaar, Jacqui Brener, Ming-Han Tsai, Masahiko Mori, Lynn Riddell, Graz Luzzi, Pieter Jooste, Thumbi Ndung'u, Bruce D Walker, Oliver G Pybus, Paul Kellam, Vivek Naranbhai, Philippa C Matthews, Astrid Gall, Philip J R Goulder
Recent studies have suggested greater HIV cure potential among infected children than adults. A major obstacle to HIV eradication in adults is that the viral reservoir is largely comprised of HIV-specific cytotoxic T lymphocyte (CTL) escape variants. We here evaluate the potential for CTL in HIV-infected slow-progressor children to play an effective role in "shock-and-kill" cure strategies. Two distinct subgroups of children were identified on the basis of viral load. Unexpectedly, in both groups, as in adults, HIV-specific CTL drove the selection of escape variants across a range of epitopes within the first weeks of infection...
November 6, 2017: Journal of Experimental Medicine
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