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Pediatric HIV Infection

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https://www.readbyqxmd.com/read/28346597/association-of-risk-of-viremia-immunosuppression-serious-clinical-events-and-mortality-with-increasing-age-in-perinatally-human-immunodeficiency-virus-infected-youth
#1
Anne M Neilan, Brad Karalius, Kunjal Patel, Russell B Van Dyke, Mark J Abzug, Allison L Agwu, Paige L Williams, Murli Purswani, Deborah Kacanek, James M Oleske, Sandra K Burchett, Andrew Wiznia, Miriam Chernoff, George R Seage, Andrea L Ciaranello
Importance: As perinatally human immunodeficiency virus-infected youth (PHIVY) in the United States grow older and more treatment experienced, clinicians need updated information about the association of age, CD4 cell count, viral load (VL), and antiretroviral (ARV) drug use with risk of opportunistic infections, key clinical events, and mortality to understand patient risks and improve care. Objective: To examine the incidence or first occurrence during follow-up of key clinical events (including Centers for Disease Control and Prevention stage B [CDC-B] and stage C [CDC-C] events) and mortality among PHIVY stratified by age, CD4 cell count, and VL and ARV status...
March 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28339668/immunogenicity-of-a-booster-dose-of-quadrivalent-meningococcal-conjugate-vaccine-in-previously-immunized-hiv-infected-children-and-youth
#2
Meredith G Warshaw, George K Siberry, Paige Williams, Michael D Decker, Patrick Jean-Philippe, Jorge Lujan-Zilbermann
Background.: The US Advisory Committee on Immunization Practices recommends a booster dose of quadrivalent meningococcal conjugate vaccine (MCV4) after initial immunization for patients at high risk for meningococcal infection. Methods.: The International Maternal Pediatric Adolescents AIDS Clinical Trials (IMPAACT) P1065 trial evaluated the use of MCV4 in human immunodeficiency virus (HIV)-infected children and youth. The final step of this trial was an open-label study of an MCV4 booster dose 3...
February 18, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28334487/growing-up-with-perinatal-human-immunodeficiency-virus-a-life-not-expected
#3
Elaine Fay Williams
AIM AND OBJECTIVES: To describe the lived experience of young adults with perinatally acquired HIV (PaHIV). BACKGROUND: The advancement of the highly active antiretroviral treatment, PaHIV-infection has transformed into a chronic lifelong illness that is faced by young adults who grew up with HIV. The known challenges that are associated with HIV are poverty, stigma and social and emotional isolation. DESIGN: This was a qualitative single interview study of a convenience sample of PaHIV-infected young adults receiving care at a large metropolitan pediatric hospital...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28329212/clinical-status-of-adolescents-with-perinatal-hiv-at-transfer-to-adult-care-in-the-uk-ireland
#4
Intira Jeannie Collins, Caroline Foster, Anna Tostevin, Pat Tookey, Andrew Riordan, David Dunn, D M Gibb, Ali Judd
Background.: Increasing numbers of children infected perinatally with human immunodeficiency virus (HIV) are surviving to adolescence and transitioning to adult care, yet there are scarce data on their clinical status at transfer. Methods.: We analyzed prospective cohort data from the UK/Ireland national Collaborative HIV Pediatric Study (CHIPS). Clinical status at last pediatric clinic visit prior to transfer was described. Factors associated with higher CD4 cell count and viral load (VL) suppression<400 c/mL among patients on antiretroviral therapy (ART) at transfer were assessed using linear and logistic regression, respectively...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329153/hiv-1-dna-decay-dynamics-with-early-long-term-virologic-control-of-perinatal-infection
#5
Priyanka Uprety, Kunjal Patel, Brad Karalius, Carrie Ziemniak, Ya Hui Chen, Sean S Brummel, Suzanne Siminski, Russell B Van Dyke, George R Seage, Deborah Persaud
Background: Early antiretroviral treatment (ART) limits proviral reservoirs, a goal for HIV-1 remission strategies. Whether this is an immediate or long-term effect of virologic suppression (VS) in perinatal infection is unknown. Methods: We quantified HIV-1 DNA longitudinally for up to 14 years in peripheral blood mononuclear cells (PBMCs) among 61 perinatally HIV-1-infected youth in the Pediatric HIV/AIDS Cohort Study who achieved VS at different ages. Group 1 (N=13) were < 1 year of age and group 2 (N=48) were between 1-5 years of age at VS...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28326084/hiv-infection-and-compromised-mucosal-immunity-oral-manifestations-and-systemic-inflammation
#6
REVIEW
Samantha E Heron, Shokrollah Elahi
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28301421/persistence-of-hiv-drug-resistance-among-south-african-children-given-nevirapine-to-prevent-mother-to-child-transmission
#7
Ruth Kanthula, Theresa Rossouw, Ute D Feucht, Gisela Van Dyk, Ingrid A Beck, Rachel Silverman, Scott Olson, Christen Salyer, Sharon Cassol, Lisa M Frenkel
OBJECTIVES: We set out to examine the prevalence and persistence of mutations conferring high-level nonnucleoside-reverse-transcriptase (NNRTI)-resistance in a cohort of HIV-infected children who had failed prophylaxis to prevent mother-to-child-transmission (PMTCT). DESIGN: A prospective observational cohort study at the Pediatric HIV Clinic at Kalafong Provincial Tertiary Hospital in Pretoria, South Africa. METHODS: Children referred for initiation of ART were enrolled from July 2010 through February 2013...
March 15, 2017: AIDS
https://www.readbyqxmd.com/read/28279683/long-term-pulmonary-complications-in-perinatally-hiv-infected-youth
#8
William T Shearer, Denise L Jacobson, Wendy Yu, George K Siberry, Murli Purswani, Suzanne Siminski, Laurie Butler, Erin Leister, Gwendolyn Scott, Russell B Van Dyke, Ram Yogev, Mary E Paul, Ana Puga, Andrew A Colin, Meyer Kattan
BACKGROUND: Increased incidence and prevalence of asthma have been documented for perinatally HIV-infected (HIV) youth 10-21 years of age (youth) compared to HIV-exposed uninfected (HEU) youth. OBJECTIVE: To perform objective pulmonary function tests (PFTs) in HIV and HEU youth with and without diagnosed asthma. METHOD: Asthma was determined in 370 participants (218 HIV, 152 HEU) by chart review and self-report at 13 sites. Interpretable PFTs (188 HIV, 132 HEU) were classified as obstructive, restrictive, or normal and reversibility was determined after bronchodilator inhalation...
March 6, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28278569/caring-for-youth-living-with-hiv-across-the-continuum-turning-gaps-into-opportunities
#9
David C Griffith, Allison L Agwu
With the increasing proportion of youth living with human immunodeficiency virus (YLHIV) and the aging of the perinatally infected population, there is a need for clinical services that are "youth friendly" to address the multiple challenges YLHIV face in terms of engagement in care and maintenance of combination antiretroviral therapy (cART). Little is known about how and where YLHIV receive their care. Further, the impact of the care structure on engagement and retention outcomes for YLHIV is ill defined...
February 13, 2017: AIDS Care
https://www.readbyqxmd.com/read/28278563/development-assessment-of-hiv-exposed-children-aged-6-18-months-a-cohort-study-from-north-india
#10
Remya Rajan, Anju Seth, Sharmila B Mukherjee, Jagdish Chandra
HIV exposed children are vulnerable to developmental delay irrespective of their HIV status due to combined effect of risk factors like poverty, prenatal drug exposure, stress and chronic illness in family and malnutrition. This cohort study assessed the development of 50 HIV exposed children aged 6-18 months at a Pediatric Centre of Excellence in HIV care in India. The development was assessed using Development Assessment Scale for Indian Infants (DASII) at enrolment, 3 and 6 months later. The development quotient (DQ) scores and proportion of children with developmental delay (DQ ≤ 70) were compared among two sub-groups, HIV infected (HI) and HIV exposed uninfected (HEU) children...
March 5, 2017: AIDS Care
https://www.readbyqxmd.com/read/28277349/missed-opportunities-for-prevention-of-mother-to-child-transmission-of-human-immunodeficiency-virus
#11
Gwendolyn B Scott, Susan B Brogly, Daniel Muenz, Alice M Stek, Jennifer S Read
OBJECTIVE: To identify missed opportunities for prevention of mother-to-child transmission of human immunodeficiency virus (HIV). METHODS: Data regarding HIV-infected children born between 2002 and 2009 to HIV-infected women enrolled in the U.S. International Maternal Pediatric Adolescent AIDS Clinical Trials prospective cohort study (protocol P1025) were reviewed. The characteristics of the HIV-infected infants and their mothers and the mothers' clinical management are described...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28261385/influence-of-vitamin-d-on-liver-fibrosis-in-chronic-hepatitis-c-a-systematic-review-and-meta-analysis-of-the-pooled-clinical-trials-data
#12
Alia S Dadabhai, Behnam Saberi, Katie Lobner, Russell T Shinohara, Gerard E Mullin
AIM: To investigate the relationship between vitamin D and liver fibrosis in hepatitis C-monoinfected or hepatitis C virus (HCV)-human immunodeficiency virus (HIV) co-infected patients. METHODS: Pertinent studies were located by a library literature search in PubMed/Embase/Cochrane/Scopus/LILACS by two individual reviewers. Inclusion criteria: (1) studies with patients with HCV or co-infected HCV/HIV; (2) studies with patients ≥ 18 years old; (3) studies that evaluated liver fibrosis stage, only based on liver biopsy; and (4) studies that reported serum or plasma 25(OH)D levels...
February 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28253476/virological-suppression-in-children-and-adolescents-is-not-influenced-by-genotyping-but-depends-on-optimal-adherence-to-antiretroviral-therapy
#13
Juliana Costa de Abreu, Sara Nunes Vaz, Eduardo Martins Netto, Carlos Brites
OBJECTIVE: To evaluate the virological outcomes in children and adolescents infected with HIV-1 in Salvador, Bahia according to genotyping results. METHODS: We retrospectively evaluated the rates of virological suppression of children and adolescents submitted to HIV-1 genotyping test from January/2008 to December/2012. The participants were followed in the two referral centers for pediatric AIDS care, in Salvador, Brazil. Resistance mutations, drug sensitivity profiles, and viral subtypes were analyzed using the Stanford HIV-1 Drug Resistance Database...
February 27, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28224079/altered-structural-brain-changes-and-neurocognitive-performance-in-pediatric-hiv
#14
Santosh K Yadav, Rakesh K Gupta, Ravindra K Garg, Vimala Venkatesh, Pradeep K Gupta, Alok K Singh, Sheema Hashem, Asma Al-Sulaiti, Deepak Kaura, Ena Wang, Francesco M Marincola, Mohammad Haris
Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28207506/higher-subcortical-and-white-matter-cerebral-blood-flow-in-perinatally-hiv-infected-children
#15
Charlotte Blokhuis, Henri J M M Mutsaerts, Sophie Cohen, Henriëtte J Scherpbier, Matthan W A Caan, Charles B L M Majoie, Taco W Kuijpers, Peter Reiss, Ferdinand W N M Wit, Dasja Pajkrt
This study aimed to evaluate cerebral blood flow (CBF) in pediatric human immunodeficiency virus (HIV)-infection, and its role in HIV-related cerebral injury and cognitive impairment.This cross-sectional observational study compared 28 perinatally HIV-infected children (8-18 years) to 34 healthy controls matched for age, sex, ethnicity, and socio-economic status. All participants underwent 3-Tesla magnetic resonance imaging, using arterial spin labeling to assess CBF in gray matter (GM), white matter (WM), basal ganglia, and thalamus...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28202762/maternal-binding-and-neutralizing-igg-responses-targeting-the-c-terminal-region-of-the-v3-loop-are-predictive-of-reduced-peripartum-hiv-1-transmission-risk
#16
David R Martinez, Nathan Vandergrift, Ayooluwa O Douglas, Erin McGuire, John Bainbridge, Nathan I Nicely, David C Montefiori, Georgia D Tomaras, Genevieve G Fouda, Sallie R Permar
The development of an effective maternal HIV-1 vaccine that could synergize with antiretroviral therapy (ART) to eliminate pediatric HIV-1 infection will require the characterization of maternal immune responses capable of blocking transmission of autologous HIV viruses to the infant. We previously identified that maternal plasma antibody binding to linear epitopes within the variable loop 3 (V3) region of HIV envelope (Env) and neutralizing responses against easy to neutralize tier 1 viruses were associated with reduced risk of peripartum HIV infection in the historic U...
February 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28192579/infectious-diseases-and-immunizations-in-international-adoption
#17
Emily Obringer, Linda Walsh
Children who are adopted internationally have an increased risk of infectious diseases due to endemic conditions and variable access to preventive health care, such as vaccines, in their country of origin. Pediatricians and other providers who care for children should be familiar with the recommended screening for newly arrived international adoptees. Testing for gastrointestinal pathogens, tuberculosis, hepatitis, syphilis, and HIV should be routinely performed. Other endemic diseases and common skin infections may need to be assessed...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192577/diagnosing-acute-hiv-infection
#18
Paul Devine Bottone, Allison H Bartlett
Acute HIV infection (AHI) represents the first 6 to 12 weeks of the disease process, when the virus is aggressively replicating in the lymphoid tissues. Accordingly, high viral loads are often present during this phase, with declining lymphocyte levels, as the CD4+ T-cell subset is preferentially commandeered to facilitate viral reproduction. Detection at this stage is imperative-the affected are often unaware, but highly infectious. Unfortunately, correct diagnosis of AHI can be challenging because the more traditional, frequently used tests, which rely on antibody detection, will often produce false-negative results during the "window period" (usually 3 to 4 weeks from infection) due to slow production of HIV antibodies...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28187062/risk-factors-for-growth-retardation-in-hiv-infected-senegalese-children-on-antiretroviral-treatment-the-anrs-12279-maggsen-pediatric-cohort-study
#19
Cecile Cames, Lea Pascal, Aminata Diack, Helene Mbodj, Baly Ouattara, Ndeye Rama Diagne, Ndeye Fatou Diallo, Philippe Msellati, Ngagne Mbaye, Haby Sy Signate
OBJECTIVES: To describe prevalence and risk factors for wasting and stunting among HIV-infected children with a median duration of 3 years of antiretroviral therapy (ART) at the time of their enrollment in the cohort study. METHODS: Wasting and stunting at ART initiation and enrollment were defined as weight-for-height/body mass index-for-age Z scores < -2 and height-for-age Z scores < -2, respectively. Logistic regression was used to assess risk factors for wasting and stunting...
April 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28168828/relative-bioavailability-of-a-dolutegravir-dispersible-tablet-and-the-effects-of-low-and-high-mineral-content-water-on-the-tablet-in-healthy-adults
#20
Ann M Buchanan, Michael Holton, Ian Conn, Mark Davies, Mike Choukour, Brian R Wynne
Dolutegravir (DTG) is approved in the United States to treat HIV-1-infected patients weighing ≥30 kg. A dispersible DTG tablet formulation was recently developed for pediatric patients. This study compares the pharmacokinetics (PK) of the dispersible tablet with that of a previously evaluated granule formulation. In this randomized, open-label, crossover study, 15 healthy adults received single oral doses of DTG 20 mg every 7 days across 5 treatment arms: granules consumed immediately after mixture with purified water, dispersible DTG consumed immediately after reconstitution in low-mineral-content (LMC) or high-mineral-content (HMC) water, and dispersible DTG consumed 30 minutes after dispersal in LMC or HMC water...
February 7, 2017: Clinical Pharmacology in Drug Development
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