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Pediatric hiv

J A Bohn, B M Kassaye, D Record, B C Chou, I L Kraft, J C Purdy, K A Hilton, D A Miller, S Getachew, A Addissie, J A Robison
BACKGROUND: Global childhood mortality rates remain high. Millennium Development Goal 4 focused efforts on reducing rates by two-thirds between 1990 and 2015. In Ethiopia, child mortality rates dropped 71 % from 1990 to 2015, however it is estimated that 184,000 Ethiopian children die each year. There is limited information about pediatric hospital admissions in Ethiopia. Our aims were to examine the temporal relationship of mortality to admission, describe the demographics, and identify cause mortality of children admitted to the Zewditu Memorial Hospital (ZMH)...
October 21, 2016: BMC Pediatrics
Jody K Takemoto, Tracie L Miller, Jiajia Wang, Denise L Jacobson, Mitchell E Geffner, Russell B Van Dyke, Mariana Gerschenson
OBJECTIVE: To identify relationships between insulin resistance (IR) and mitochondrial respiration in perinatally HIV-infected (pHIV) youth. DESIGN: Case-control study METHODS:: Mitochondrial respiration was assessed in pHIV youth in Tanner stages 2-5, 25 youth with IR (IR+) and 50 without IR (IR-) who were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS). IR was defined as a Homeostatic Model of Assessment for Insulin Resistance (HOMA-IR) value ≥4.0. A novel, high-throughput oximetry method was used to evaluate cellular respiration in peripheral blood mononuclear cells...
October 14, 2016: AIDS
Linda Aurpibul, Sirinya Teerananchai, Wasana Prasitsuebsai, Tavitiya Sudjaritruk, Pope Kosalaraksa, Nia Kurniati, Khanh Huu Truong, Viet Chau Do, Lam Van Nguyen, Kulkanya Chokephaibulkit, Thida Singtoroj, Stephen J Kerr
BACKGROUND: Failure rates of second-line boosted protease inhibitor antiretroviral therapy regimens in children rise over time. Therapeutic drug monitoring (TDM) can contribute to assessments of adherence. The authors assessed the performance characteristics of the US DHHS-recommended lopinavir (LPV) concentration of 1.0 mg/L for predicting virologic failure (VF) and intermediate-to-high level LPV resistance in Asian children. MATERIALS AND METHODS: LPV concentration, HIV RNA level, and adherence data from study participants in Indonesia, Thailand, and Vietnam receiving second-line LPV-based ART and followed for ≥24 weeks were analyzed...
August 1, 2016: Therapeutic Drug Monitoring
R M Dorman, L M Yee, S H Sutton
In our perinatal HIV cohort, we have observed difficulty swallowing pills as a frequent and significant barrier to adherence to highly active antiretroviral therapy. We refer to this problem as pill aversion and define it as difficulty swallowing pills with no persistent medical or structural cause as well as the anxiety and physical symptoms associated with pill swallowing. By applying cognitive behavioral theory to behavioral patterns within our pregnant HIV-infected population, we seek to better understand the development and reinforcement of pill aversion behavior...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Gadavalli Vera Venkata Satyakiran, Radhika Manoj Bavle, Glory Alexander, Saritha Rao, Reshma Venugopal, Sreelatha S Hosthor
INTRODUCTION: Human immunodeficiency virus (HIV) infection gradually destroys the body's immune system, which makes it harder for the body to fight infections. HIV infection causes a quantitative and qualitative depletion of CD4 lymphocyte count, which increases the risk of opportunistic infections. Thus, CD4 count is one of the key factors in determining both the urgency of highly active antiretroviral therapy (HAART) initiation and the need of prophylaxis for opportunistic infections...
September 2016: Journal of Oral and Maxillofacial Pathology: JOMFP
Mary-Ann Davies, Diana Gibb, Anna Turkova
PURPOSE OF REVIEW: It is 20 years since the start of the combination antiretroviral therapy (cART) era and more than 10 years since cART scale-up began in resource-limited settings. We examined survival of vertically HIV-infected infants and children in the cART era. RECENT FINDINGS: Good survival has been achieved on cART in all settings with up to 10-fold mortality reductions compared with before cART availability. Although mortality risk remains high in the first few months after cART initiation in young children with severe disease, it drops rapidly thereafter even for those who started with advanced disease, and longer term mortality risk is low...
September 2016: Current Opinion in HIV and AIDS
Rebecca J Brown, David Araujo-Vilar, Pik To Cheung, David Dunger, Abhimanyu Garg, Michelle Jack, Lucy Mungai, Elif A Oral, Nivedita Patni, Kristina Rother, Julia von Schnurbein, Ekaterina Sorkina, Takara Stanley, Corinne Vigouroux, Martin Wabitsch, Rachel Williams, Tohru Yorifuji
OBJECTIVE: Lipodystrophy syndromes are extremely rare disorders of deficient body fat associated with potentially serious metabolic complications, including diabetes, hypertriglyceridemia, and steatohepatitis. Due to their rarity, most clinicians are not familiar with their diagnosis and management. This practice guideline summarizes diagnosis and management of lipodystrophy syndromes not associated with HIV or injectable drugs. PARTICIPANTS: Seventeen participants were nominated by worldwide endocrine societies or selected by the committee as content experts...
October 6, 2016: Journal of Clinical Endocrinology and Metabolism
Raymond M Johnson, Kelly R Bergmann, John J Manaloor, Xiaoqing Yu, James E Slaven, Anupam B Kharbanda
Background.  Pediatric Kawasaki disease (KD) and human immunodeficiency virus (HIV)(+) adult Kawasaki-like syndrome (KLS) are dramatic vasculitides with similar physical findings. Both syndromes include unusual arterial histopathology with immunoglobulin (Ig)A(+) plasma cells, and both impressively respond to pooled Ig therapy. Their distinctive presentations, histopathology, and therapeutic response suggest a common etiology. Because blood is in immediate contact with inflamed arteries, we investigated whether KD and KLS share an inflammatory signature in serum...
September 2016: Open Forum Infectious Diseases
Aritra Das, Roger Detels, Abdelmonem A Afifi, Marjan Javanbakht, Frank Sorvillo, Samiran Panda
In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the "Pediatric Quality of Life Inventory" and two HIV-targeted scales-"symptoms" and "discrimination." A piloting exercise involving groups of children living with HIV and HIV-negative children born to HIV-infected parents provided evidence for the acceptable psychometric properties and usability of the instrument...
October 3, 2016: Journal of Health Psychology
Elizabeth Park, Tiny Masupe, Joseph Joseph, Ari Ho-Foster, Afton Chavez, Swetha Jammalamadugu, Andrew Marek, Ruth Arumala, Dineo Ketshogileng, Ryan Littman-Quinn, Carrie Kovarik
BACKGROUND: Since the UN Human Rights Council's recognition on the subject in 2011, the right to access the Internet and information is now considered one of the most basic human rights of global citizens [1,2]. Despite this, an information gap between developed and resource-limited countries remains, and there is scant research on actual information needs of workers themselves. The Republic of Botswana represents a fertile ground to address existing gaps in research, policy, and practice, due to its demonstrated gap in access to information and specialists among rural health care workers (HCWs), burgeoning mHealth capacity, and a timely offer from Orange Telecommunications to access Wikipedia for free on mobile platforms for Botswana subscribers...
November 2016: International Journal of Medical Informatics
Ann M Moormann, Jeffrey A Bailey
Burkitt lymphoma (BL) is >90% EBV-associated when this pediatric cancer is diagnosed in regions heavily burden by endemic Plasmodium falciparum malaria and thus has been geographically classified as endemic BL. The incidence of endemic BL is 10-fold higher compared to BL diagnosed in non-malarious regions of the world. The other forms of BL have been classified as sporadic BL which contain EBV in ∼30% of cases and immunodeficiency BL which occurs in HIV-infected adults with ∼40% of tumors containing EBV...
September 26, 2016: Current Opinion in Virology
Rakesh Reddy, Ajay Gogia, Lalit Kumar, Atul Sharma, Sameer Bakhshi, Mehar C Sharma, Saumyaranjan Mallick, Ranjit Sahoo
CONTEXT AND AIM: Data on HIV associated hematologic malignancies is sparse from India. This study attempts to analyze the spectrum and features of this disease at a tertiary cancer center in India. SETTING AND METHODS: Retrospective study from case records of patients registered with a diagnosis of hematologic malignancy and HIV infection between January 2010 and June 2015. RESULTS: Thirteen cases of HIV associated hematologic malignancies were identified, six of them pediatric...
July 2016: Indian Journal of Medical and Paediatric Oncology
Maximilian Muenchhoff, Emily Adland, Owen Karimanzira, Carol Crowther, Matthew Pace, Anna Csala, Ellen Leitman, Angeline Moonsamy, Callum McGregor, Jacob Hurst, Andreas Groll, Masahiko Mori, Smruti Sinmyee, Christina Thobakgale, Gareth Tudor-Williams, Andrew J Prendergast, Henrik Kloverpris, Julia Roider, Alasdair Leslie, Delane Shingadia, Thea Brits, Samantha Daniels, John Frater, Christian B Willberg, Bruce D Walker, Thumbi Ndung'u, Pieter Jooste, Penny L Moore, Lynn Morris, Philip Goulder
Disease-free infection in HIV-infected adults is associated with human leukocyte antigen-mediated suppression of viremia, whereas in the sooty mangabey and other healthy natural hosts of simian immunodeficiency virus (SIV), viral replication continues unabated. To better understand factors preventing HIV disease, we investigated pediatric infection, where AIDS typically develops more rapidly than in adults. Among 170 nonprogressing antiretroviral therapy-naïve children aged >5 years maintaining normal-for-age CD4 T cell counts, immune activation levels were low despite high viremia (median, 26,000 copies/ml)...
September 28, 2016: Science Translational Medicine
Ann Chahroudi, Guido Silvestri
A subset of HIV-infected children shows an unusually benign course of infection that recapitulates key immunological aspects of the natural SIV infection of sooty mangabeys (Muenchhoff et al.).
September 28, 2016: Science Translational Medicine
Ragna S Boerma, T Sonia Boender, Anton P Bussink, Job C J Calis, Silvia Bertagnolio, Tobias F Rinke de Wit, Michael Boele van Hensbroek, Kim C E Sigaloff
BACKGROUND:  The 90-90-90 goals aim to achieve viral suppression in 90% of all HIV-infected people on antiretroviral treatment (ART), which is especially challenging in children. Global estimates of viral suppression among children in low- and middle-income countries (LMIC) are lacking. This study summarizes viral suppression rates in children on first-line ART in LMIC since the year 2000. METHODS:  We searched for randomized controlled trials and observational studies and analyzed viral suppression rates among children started on ART during three time periods, based on major World Health Organization (WHO) guideline changes: early (2000-2005), intermediate (2006-2009), and current (2010 and later), using random effects meta-analysis...
September 22, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Anjuli D Wagner, Cyrus M Wachira, Irene N Njuguna, Elizabeth Maleche-Obimbo, Kenneth Sherr, Irene W Inwani, James P Hughes, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
OBJECTIVES: Few routine systems exist to test older, asymptomatic children for HIV. Testing all children in the population has high uptake but is inefficient, while testing only symptomatic children increases efficiency but misses opportunities to optimize outcomes. Testing children of HIV-infected adults in care may efficiently identify previously undiagnosed HIV-infected children before symptomatic disease. METHODS: HIV-infected parents in HIV care in Nairobi, Kenya were systematically asked about their children's HIV status and testing history...
September 19, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Pierre Frange, Naïm Bouazza, Patricia Fassinou, Josiane Warszawski, Stéphane Blanche
INTRODUCTION: Antiretroviral therapy is extremely effective in both children and adults infected with HIV. Treatment indications have rapidly expanded; ideally, with rare exceptions, all infected children should now be treated. AREAS COVERED: The use of antiretroviral drugs in children is based largely on extrapolations from experience with adult patients. Pharmacokinetic studies are required in addition to formal studies, which are difficult to conduct in pediatric situations, extending from birth to adolescence...
September 22, 2016: Expert Review of Anti-infective Therapy
Muzamil Ashraf Makhdoomi, Deepti Singh, Ambili Nair Pananghat, Rakesh Lodha, Sushil Kumar Kabra, Kalpana Luthra
Anti-HIV-1 broadly neutralizing antibodies (bnAbs) have been extensively tested against pesudoviruses of diverse strains. We generated and characterized HIV-1 primary isolates from antiretroviral naïve infected Indian children, and determined their susceptibility to known NAbs. All the 8 isolates belonged to subtype-C and were R5 tropic. Majority of these viruses were resistant to neutralization by NAbs, suggesting that the bnAbs, known to efficiently neutralize pseudoviruses (adult and pediatric) of different strains, are less effective against pediatric primary isolates...
September 16, 2016: Virology
Lemi Mosissa, Abebaw Kebede, Tedla Mindaye, Muluwork Getahun, Sisay Tulu, Kassu Desta
Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes...
2016: Pan African Medical Journal
Ragna S Boerma, Cissy Kityo, T Sonia Boender, Elizabeth Kaudha, Joshua Kayiwa, Victor Musiime, Andrew Mukuye, Mary Kiconco, Immaculate Nankya, Lilian Nakatudde, Peter N Mugyenyi, Michael Boele van Hensbroek, Tobias F Rinke de Wit, Kim C E Sigaloff, Job C J Calis
BACKGROUND: Data on pediatric second-line antiretroviral treatment (ART) outcomes are scarce, but essential to evaluate second-line and design third-line regimens. METHODS: Children ≤12 years switching to second-line ART containing a protease inhibitor (PI) in Uganda were followed for 24 months. Viral load (VL) was determined at switch to second-line and every 6 months thereafter; genotypic resistance testing was done if VL ≥ 1000 cps/ml. RESULTS: 60 children were included in the analysis; all had ≥1 drug resistance mutations at switch...
September 15, 2016: Journal of Tropical Pediatrics
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