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Pediatric hiv

Thomas Magg, Tilmann Schober, Christoph Walz, Julia Ley-Zaporozhan, Fabio Facchetti, Christoph Klein, Fabian Hauck
Epstein-Barr virus positive (EBV+ ) smooth muscle tumors (SMTs) constitute a very rare oncological entity. They usually develop in the context of secondary immunodeficiency caused by human immunodeficiency virus infection or immunosuppressive treatment after solid organ transplantation. However, in a small fraction of predominantly pediatric patients, EBV+ SMTs may occur in patients with primary immunodeficiency disorders (PIDs), such as GATA2 and CARMIL2 deficiency. In secondary immunodeficiencies and when the underlying condition can not be cured, the treatment of EBV+ SMTs is based on surgery in combination with antiretroviral and reduced or altered immunosuppressive pharmacotherapy, respectively...
2018: Frontiers in Immunology
Xavier Tchetnya, Calypse Asangbe Ngwasiri, Tiayah Munge, Leopold Ndemnge Aminde
BACKGROUND: Toxic epidermal necrolysis (TEN) is a rare life threatening dermatological disorder characterized by extensive epidermal detachment and erosion of mucous membranes. It is typically a side effect of some medications. Nevirapine, a nonnucleoside reverse transcriptase inhibitor (NNRTI) is one of the frequently used components of highly active antiretroviral therapy (HAART). Skin rash is its common adverse reaction, usually mild and rarely progressing to TEN. Ophthalmic involvement is common as well but rarely progresses to blindness especially in the pediatric population...
March 13, 2018: BMC Pediatrics
Hayley K Hutton, Heather J Zar, Andrew C Argent
Aim: Severe acute lower respiratory tract infection (ALRTI) remains an important cause of childhood morbidity and mortality. Methods: This is a 12-month retrospective cohort study of children (0-12 years) admitted to a pediatric intensive care unit (PICU) with ALRTI to investigate risk factors, clinical course and in-hospital survival. Results: In total, 265 patients (median age = 4 months [2-12 months]) were identified. In all,102 (38...
March 9, 2018: Journal of Tropical Pediatrics
Ahizechukwu C Eke, Nahida Chakhtoura, Angela Kashuba, Brookie M Best, Craig Sykes, Jiajia Wang, Alice M Stek, Elizabeth Smith, Samantha Calabrese, Edmund V Capparelli, Mark Mirochnick
BACKGROUND: Concentrations of antiretrovirals (ARVs) in the genital tract play a key role in pre-exposure prophylaxis. This study aims to describe rilpivirine (Edurant) concentrations in the genital tract in pregnant and postpartum women. METHODS: International Maternal Pediatric Adolescent AIDS Clinical Trials Protocol P1026s is an ongoing, prospective study of antiretroviral pharmacokinetics (PK) in HIV infected pregnant women that include a cohort receiving rilpivirine combination regimen...
March 8, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Anna Starshinova, Viacheslav Zhuravlev, Irina Dovgaluk, Alexandr Panteleev, Vera Manina, Ulia Zinchenko, Evgenia Istomina, Maria Pavlova, Piotr Yablonskiy
Background: The WHO strategy for eradication of tuberculosis (TB) by 2035 (The End TB Strategy) is aimed at an early and precise diagnosis and subsequent effective treatment of TB patients. Currently, there is no gold standard for the diagnosis of latent TB infection. This study evaluated the diagnostic capabilities of a new intradermal test using recombinant TB allergen (Diaskintest) compared with tuberculin skin test (TST) and commercial TB interferon-gamma release assays (IGRAs). Methods: A post-hoc data analysis that involved examining 860 HIV-negative, bacillus Calmette-Guérin (BCG)-vaccinated persons aged 1-65 years who visited the TB health-care institutions of Saint Petersburg to rule out or confirm an active TB was conducted from 2011 to 2016...
January 2018: International Journal of Mycobacteriology
Lisa Frigati, Moherdran Archary, Helena Rabie, Martina Penazzato, Nathan Ford
Early mortality and morbidity remain high in children initiating antiretroviral therapy (ART), especially in sub-Saharan Africa. Many children still present with advanced human immunodeficiency virus (HIV) disease. Tuberculosis, pneumonia, and severe bacterial infections are the main causes of hospital admission in HIV-infected children. In contrast to adults with advanced HIV disease, cryptococcal disease is not common in childhood, although there is a peak in infancy and adolescence. Interventions such as TB screening in symptomatic children, and isoniazid and cotrimoxazole prophylaxis should be implemented...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Dvora Joseph Davey, Elise Farley, Yolanda Gomba, Thomas Coates, Landon Myer
BACKGROUND: HIV acquisition in pregnancy and breastfeeding contributes significantly toward pediatric HIV infection. However, little is known about how sexual behavior changes during pregnancy and postpartum periods which will help develop targeted HIV prevention and transmission interventions, including pre-exposure prophylaxis (PrEP). METHODS: Cross-sectional study in HIV-infected and uninfected pregnant and postpartum women in Cape Town, South Africa. Interviewers collected survey data on demographic, sexual behaviors, and alcohol use among pregnant and post-partum women...
2018: PloS One
Kara Wools-Kaloustian, Irene Marete, Samuel Ayaya, Annette H Sohn, Lam Van Nguyen, Shanshan Li, Valériane Leroy, Beverly S Musick, Jamie E Newman, Andrew Edmonds, Mary-Ann Davies, François Tanoh Eboua, Marie-Thérèse Obama, Marcel Yotebieng, Shobna Sawry, Lynne M Mofenson, Constantin T Yiannoutsos
BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2-14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis...
March 2, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Amy L Slogrove, Michael Schomaker, Mary-Ann Davies, Paige Williams, Suna Balkan, Jihane Ben-Farhat, Nancy Calles, Kulkanya Chokephaibulkit, Charlotte Duff, Tanoh François Eboua, Adeodata Kekitiinwa-Rukyalekere, Nicola Maxwell, Jorge Pinto, George Seage, Chloe A Teasdale, Sebastian Wanless, Josiane Warszawski, Kara Wools-Kaloustian, Marcel Yotebieng, Venessa Timmerman, Intira J Collins, Ruth Goodall, Colette Smith, Kunjal Patel, Mary Paul, Diana Gibb, Rachel Vreeman, Elaine J Abrams, Rohan Hazra, Russell Van Dyke, Linda-Gail Bekker, Lynne Mofenson, Marissa Vicari, Shaffiq Essajee, Martina Penazzato, Gabriel Anabwani, Edith Q Mohapi, Peter N Kazembe, Makhosazana Hlatshwayo, Mwita Lumumba, Tessa Goetghebuer, Claire Thorne, Luisa Galli, Annemarie van Rossum, Carlo Giaquinto, Magdalena Marczynska, Laura Marques, Filipa Prata, Luminita Ene, Liubov Okhonskaia, Pablo Rojo, Claudia Fortuny, Lars Naver, Christoph Rudin, Sophie Le Coeur, Alla Volokha, Vanessa Rouzier, Regina Succi, Annette Sohn, Azar Kariminia, Andrew Edmonds, Patricia Lelo, Samuel Ayaya, Patricia Ongwen, Laura F Jefferys, Sam Phiri, Mwangelwa Mubiana-Mbewe, Shobna Sawry, Lorna Renner, Mariam Sylla, Mark J Abzug, Myron Levin, James Oleske, Miriam Chernoff, Shirley Traite, Murli Purswani, Ellen G Chadwick, Ali Judd, Valériane Leroy
BACKGROUND: Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia...
March 2018: PLoS Medicine
Lucie Cluver, Marija Pantelic, Mark Orkin, Elona Toska, Sally Medley, Lorraine Sherr
INTRODUCTION: The Sustainable Development Goals (SDGs) present a groundbreaking global development agenda to protect the most vulnerable. Adolescents living with HIV in Sub-Saharan Africa continue to experience extreme health vulnerabilities, but we know little about the impacts of SDG-aligned provisions on their health. This study tests associations of provisions aligned with five SDGs with potential mortality risks. METHODS: Clinical and interview data were gathered from N = 1060 adolescents living with HIV in rural and urban South Africa in 2014 to 2015...
February 2018: Journal of the International AIDS Society
Amanda Willig, Lauri Wright, Theresa A Galvin
Nutrition is an integral component of medical care for people living with human immunodeficiency virus (HIV)/autoimmune deficiency syndrome (AIDS) (PLWHA). The Academy of Nutrition and Dietetics supports integration of medical nutrition therapy into routine care for this population. Fewer PLWHA experience wasting and undernutrition, while the prevalence of obesity and other chronic diseases has increased significantly. Improved understanding of HIV infection's impact on metabolism and chronic inflammation has only increased the complexity of managing chronic HIV infection...
March 2018: Journal of the Academy of Nutrition and Dietetics
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
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
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
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
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
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
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
William J Muller, Ellen G Chadwick
Exposures that carry risk of transmission of blood-borne disease are rare in pediatrics, but expose patients and families to great anxiety. Specialists in pediatric infectious diseases are often asked about initial antimicrobial prophylaxis in these cases. Guidelines for nonoccupational postexposure prophylaxis for human immunodeficiency virus have evolved as new formulations and medications become available and greater experience obtained in assessing relative risks of different exposures and relative costs and benefits for different interventions...
March 2018: Infectious Disease Clinics of North America
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
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