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https://www.readbyqxmd.com/read/29324985/urine-tb-lipoarabinomannan-lam-predicts-mortality-in-hospitalized-hiv-infected-children
#1
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/29324811/scale-up-of-kenya-s-national-hiv-viral-load-program-findings-and-lessons-learned
#2
Matilu Mwau, Catherine Akinyi Syeunda, Maureen Adhiambo, Priska Bwana, Lucy Kithinji, Joy Mwende, Laura Oyiengo, Martin Sirengo, Caroline E Boeke
OBJECTIVES: Kenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought to assess program scale up using the national database and identify areas for systems strengthening. METHODS: Data from January 2012 to March 2016 were extracted from Kenya's national viral load database. Characteristics of 1,108,356 tests were assessed over time, including reason for testing, turnaround times, test results, treatment regimens, and socio-demographic information...
2018: PloS One
https://www.readbyqxmd.com/read/29323688/preventing-hiv-infection-what-pediatricians-should-know-about-hiv-pre-exposure-prophylaxis
#3
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/29323687/pediatric-endocrinology-lead-toxicity-in-sickle-cell-disease-and-hiv-pre-exposure-prophylaxis
#4
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
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/29313586/eosinophilic-ascites-rarest-presentation-of-a-rare-disease-eosinophilic-gastroenteritis
#6
Iqbal Bagasarawala, J K Maniar, Abizer Manked, Hozefa Runderawala
Eosinophilic gastroenteritis (EGE) is an uncommon disease of unknown etiology reported in both adult and pediatric age group. Here we report a case of a 46-year-old HIV positive female who presented to us with ascites and abdominal distension with peripheral eosinophilia and diagnosed as EGE.
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29303843/cognition-emotional-health-and-immunological-markers-in-children-with-long-term-nonprogressive-hiv
#7
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/29302174/neglected-population-neglected-right-children-living-with-hiv-and-the-right-to-science
#8
Michael L Scanlon, Gillian MacNaughton, Courtenay Sprague
The laws, language, and tools of human rights have been instrumental in expanding access to lifesaving treatment for people living with HIV. Children, however, remain a neglected population, as evidenced by inadequate child-specific and child-friendly HIV treatment options. In this article, we explore the right to science, a potentially powerful but underdeveloped right in international law, and its application to research and development for pediatric HIV treatment. Drawing on reports of human rights bodies and scholars and applying the human rights typology of state obligations to respect, protect, and fulfill, we argue that states have five core obligations related to research and development for child-specific and child-friendly treatment: (1) adopting a public goods approach to science and science policy; (2) including and protecting children in research activities; (3) adopting legal and policy frameworks to support research and development through public funding and private sector incentives; (4) promoting international cooperation and assistance; and (5) ensuring the participation of marginalized communities in decision-making processes...
December 2017: Health and Human Rights
https://www.readbyqxmd.com/read/29287090/immune-activation-despite-preserved-cd4-t-cells-in-perinatally-hiv-infected-children-and-adolescents
#9
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
#10
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
#11
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
#12
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
#13
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/29278615/risk-for-speech-and-language-impairments-in-pre-school-aged-hiv-exposed-uninfected-children-with-in-utero-combination-antiretroviral-exposure
#14
Mabel L Rice, Jonathan S Russell, Toni Frederick, Murli Purswani, Paige L Williams, George K Siberry, Sean M Redmond, Howard J Hoffman, Tzy-Jyun Yao
BACKGROUND: Perinatally HIV-exposed but uninfected (HEU) children have elevated risk of late language emergence at age 1 year, with possible links to in utero antiretroviral (ARV) exposure. We investigated possible risks for speech impairments (SI) and language impairments (LI) in preschool monolingual HEU children in the United States. METHODS: Speech and language assessments were conducted as part of the PHACS Surveillance Monitoring of ART Toxicities (SMARTT) study at ages 3 (N= 208) and 5 (N = 429) years...
December 22, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29260263/systematic-literature-review-on-the-incidence-and-prevalence-of-heart-failure-in-children-and-adolescents
#15
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
#16
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
#17
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/29243498/-cart-intensification-by-the-hiv-1-tat-b-clade-vaccine-progress-to-phase-iii-efficacy-studies
#18
Aurelio Cafaro, Cecilia Sgadari, Orietta Picconi, Antonella Tripiciano, Sonia Moretti, Vittorio Francavilla, Maria Rosaria Pavone Cossut, Stefano Buttò, Giovanni Cozzone, Fabrizio Ensoli, Paolo Monini, Barbara Ensoli
In spite of its success at suppressing HIV replication, combination antiretroviral therapy (cART) only partially reduces immune dysregulation and loss of immune functions. These cART-unmet needs appear to be due to persistent virus replication and cell-to-cell transmission in reservoirs, and are causes of increased patients' morbidity and mortality. Up to now, therapeutic interventions aimed at cART-intensification by attacking the virus reservoir have failed. Areas covered: We briefly review the rationale and clinical development of Tat therapeutic vaccine in cART-treated subjects in Italy and South Africa (SA)...
December 15, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/29237487/adolescent-coordinated-transition-act-to-improve-health-outcomes-among-young-people-living-with-hiv-in-nigeria-study-protocol-for-a-randomized-controlled-trial
#19
Nadia A Sam-Agudu, Jennifer R Pharr, Tamara Bruno, Chad L Cross, Llewellyn J Cornelius, Prosper Okonkwo, Bolanle Oyeledun, Hadiza Khamofu, Ayodotun Olutola, Salome Erekaha, William Nii Ayitey Menson, Echezona E Ezeanolue
BACKGROUND: Adolescents living with HIV (ALHIV) have worse health outcomes than other populations of people living with HIV. Contributing factors include lack of standard and comprehensive procedures for ALHIV transitioning from pediatric to adult care. This has contributed to poor retention at, and following transition, which is problematic especially in high ALHIV-burden, resource-limited settings like Nigeria. METHODS: Using a two-arm cluster randomized control design, the Adolescent Coordinated Transition (ACT) trial will measure the comparative effectiveness of a graduated transition and organized support group intervention against the usual practice of abrupt transfer of Nigerian ALHIV from pediatric to adult care...
December 14, 2017: Trials
https://www.readbyqxmd.com/read/29237287/early-sites-of-virus-replication-after-oral-sivmac251-infection-of-infant-macaques-implications-for-pathogenesis
#20
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
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