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https://www.readbyqxmd.com/read/29218501/evaluating-safety-reporting-in-paediatric-antibiotic-trials-2000-2016-a-systematic-review-and-meta-analysis
#1
REVIEW
Paola Pansa, Yingfen Hsia, Julia Bielicki, Irja Lutsar, A Sarah Walker, Mike Sharland, Laura Folgori
BACKGROUND: There are very few options to treat multidrug-resistant bacterial infections in children. A major barrier is the duration and complexity of regulatory trials of new antibiotics. Extrapolation of safety data from adult trials could facilitate drug development for children. OBJECTIVE: We performed a systematic review on the safety of antibiotic clinical trials (CTs) in children (0-18 years) to evaluate the overall quality of safety trials conducted in children and to determine if age-specific adverse events (AEs) could be identified for specific antibiotic classes...
December 7, 2017: Drugs
https://www.readbyqxmd.com/read/29216874/factors-influencing-the-experience-of-sexual-and-reproductive-healthcare-for-female-adolescents-with-perinatally-acquired-hiv-a-qualitative-case-study
#2
Gertrude Mwalabu, Catrin Evans, Sarah Redsell
BACKGROUND: Young people living with perinatally-acquired HIV require age-appropriate support regarding sex and relationships as they progress towards adulthood. HIV affects both genders but evidence suggests that young women are particularly vulnerable to sexual abuse and more prone to engaging in sexual behaviours to meet their daily survival needs. This can result in poor sexual and reproductive health (SRH) outcomes. HIV services in Malawi provide support for young women's HIV-related clinical needs, but it is unclear whether there is sufficient provision for their SRH needs as they become adults...
December 8, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29210712/optimizing-hiv-transition-services-for-young-adults
#3
Caroline Foster, Sarah Fidler
PURPOSE OF REVIEW: A total of 1.8 million adolescents live with HIV and constitute the only age group in which HIV-associated mortality continues to rise. Meeting their healthcare needs as they transition from paediatric services to adult care is vital for their own health and in prevention of onward transmission to partners and offspring. In this review, we discuss the issues around transition, both within HIV health care and the wider transitions adolescents negotiate as they move out of childhood and into adult life...
November 27, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29209922/altered-brain-morphometry-in-7-year-old-hiv-infected-children-on-early-art
#4
Emmanuel C Nwosu, Frances C Robertson, Martha J Holmes, Mark F Cotton, Els Dobbels, Francesca Little, Barbara Laughton, Andre van der Kouwe, Ernesta M Meintjes
Even with the increased roll out of combination antiretroviral therapy (cART), paediatric HIV infection is associated with neurodevelopmental delays and neurocognitive deficits that may be accompanied by alterations in brain structure. Few neuroimaging studies have been done in children initiating ART before 2 years of age, and even fewer in children within the critical stage of brain development between 5 and 11 years. We hypothesized that early ART would limit HIV-related brain morphometric deficits at age 7...
December 5, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29190337/optimizing-research-to-speed-up-availability-of-pediatric-antiretroviral-drugs-and-formulations
#5
Martina Penazzato, Devasena Gnanashanmugam, Pablo Rojo, Marc Lallemant, Linda L Lewis, Francesca Rocchi, Agnes Saint Raymond, Nathan Ford, Rohan Hazra, Carlo Giaquinto, Yodit Belew, Diana M Gibb, Elaine J Abrams
Globally 1.8 million children are living with human immunodeficiency virus (HIV), yet only 51% of those eligible actually start treatment. Research and development (R&D) for pediatric antiretrovirals (ARVs) is a lengthy process and lags considerably behind drug development in adults. Providing safe, effective, and well-tolerated drugs for children remains critical to ensuring scale-up globally. We review current approaches to R&D for pediatric ARVs and suggest innovations to enable simplified, faster, and more comprehensive strategies to develop optimal formulations...
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29181714/discontinuation-of-efavirenz-in-paediatric-patients-why-do-children-switch
#6
Elke Wynberg, Eleri Williams, Gareth Tudor-Williams, Hermione Lyall, Caroline Foster
BACKGROUND: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents...
November 27, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29173570/-refusal-of-care-by-a-hiv-positive-adolescent-role-of-the-cross-cultural-approach
#7
Nora Bouaziz, Alice Titia Rizzi
The refusal of treatment is frequent in human immunodeficiency virus-positive adolescents. The clinical history of a teenage girl presenting severe immunodepression secondary to the virus, a depressive disorder and a refusal of treatment, illustrates the benefit of combined paediatric, child psychiatric and cross-cultural care as proposed by the Cochin-Paris Adolescent Centre. Working on the meaning of the refusal was a prerequisite for the construction of a care project forming part of a life project, as the psychopathological work could only begin once somatic care ensuring the patient's protection was in place...
November 2017: Soins. Psychiatrie
https://www.readbyqxmd.com/read/29171190/routine-viral-load-monitoring-in-hiv-infected-infants-and-children-in-low-and-middle-income-countries-challenges-and-opportunities
#8
Stephen M Arpadi, Stephanie Shiau, Eduarda Pimentel De Gusmao, Avy Violari
INTRODUCTION: The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferred monitoring approach for all individuals treated with ART in order to assess treatment response, detect treatment failure and determine the need to switch to a second-line regimen in a timely manner...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29140587/comparison-of-haematology-and-biochemistry-parameters-in-healthy-south-african-infants-with-laboratory-reference-intervals
#9
B Schmidt, M Tameris, H Geldenhuys, A Luabeya, E Bunyasi, T Hawkridge, J B McClain, H Mahomed, T J Scriba, H McShane, M Hatherill
OBJECTIVE: Paediatric laboratory reference intervals used in Africa and Asia may be derived from historical intervals of predominantly Caucasian infants in Europe or North America. These intervals may therefore not be compatible with the range of normality for developing country populations. We aimed to compare haematology and biochemistry parameters in healthy South African infants with local laboratory reference intervals. METHODS: We compared the baseline haematology and biochemistry results of 634 (316 male and 318 female) HIV-unexposed infants, aged 3-6 months, living in a rural area of the Western Cape Province, South Africa, against laboratory reference intervals supplied by the South African National Health Laboratory Services (NHLS)...
November 15, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29133560/levofloxacin-population-pharmacokinetics-in-south-african-children-treated-for-multidrug-resistant-tuberculosis
#10
Paolo Denti, Anthony J Garcia-Prats, Heather R Draper, Lubbe Wiesner, Jana Winckler, Stephanie Thee, Kelly E Dooley, Rada M Savic, Helen M McIlleron, H Simon Schaaf, Anneke C Hesseling
Background: Levofloxacin is increasingly used in the treatment of multidrug-resistant tuberculosis (MDR-TB). There are limited paediatric pharmacokinetic data to inform dose selection for children.Methods: Children routinely receiving levofloxacin (250 mg adult tablets) for MDR-TB prophylaxis or disease in Cape Town, South Africa, underwent pharmacokinetic sampling following a 15 or 20 mg/kg dose, given as whole tablet(s) or crushed, orally, or by nasogastric tube. Pharmacokinetic parameters were estimated using non-linear mixed effects modelling...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29132283/predictors-of-survival-among-hiv-positive-children-on-art-in-swaziland
#11
Patrick Shabangu, Andy Beke, Samuel Manda, Nobuhle Mthethwa
The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29126299/cns-penetration-of-art-in-hiv-infected-children
#12
Malon Van den Hof, Charlotte Blokhuis, Sophie Cohen, Henriette J Scherpbier, Ferdinand W N M Wit, M C M Pistorius, Neeltje A Kootstra, Charlotte E Teunissen, Ron A A Mathot, Dasja Pajkrt
Background: Paediatric data on CNS penetration of antiretroviral drugs are scarce. Objectives: To evaluate CNS penetration of antiretroviral drugs in HIV-infected children and explore associations with neurocognitive function. Patients and methods: Antiretroviral drug levels were measured in paired CSF and blood samples of clinically stable HIV-infected children between 8 and 18 years old on long-term combined ART. Plasma drug concentrations were corrected for protein binding...
November 8, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29081934/congenital-vitiligo-a-case-observed-in-the-cohort-of-hiv-exposed-infants-in-bobo-dioulasso-burkina-faso
#13
Makoura Barro, Jean W Diallo, Ad Bafa Ibrahim Ouattara, Boubacar Nacro
Vitiligo is a dermatological disease; its exact prevalence is unknown among the paediatric population. We are reporting a case of vitiligo at birth for the first time in Burkina Faso, in the Teaching Hospital Souro Sanou of Bobo-Dioulasso, Paediatric Department. He is a male child, born from HIV-1 positive parents; we received him when he was 2 months to be followed in connection with the prevention of motherto-child transmission. He showed achromic lesions on the skin and on skin appendages at birth. In addition to congenital vitiligo we mentioned, several diagnostic hypotheses were discussed...
October 6, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/29069378/the-effect-of-a-performance-based-financing-program-on-hiv-and-maternal-child-health-services-in-mozambique-an-impact-evaluation
#14
Yogesh Rajkotia, Omer Zang, Pierre Nguimkeu, Jessica Gergen, Iva Djurovic, Paula Vaz, Franscisco Mbofana, Kebba Jobarteh
Performance-based financing (PBF) is a mechanism by which health providers are paid on the basis of outputs or results delivered. A PBF program was implemented on the provision of HIV, prevention of mother-to child HIV transmission (PMTCT), and maternal/child health (MCH) services in two provinces of Mozambique. A retrospective case-control study design was used in which PBF provinces were matched with control provinces to evaluate the impact of PBF on 18 indicators. Due to regional heterogeneity, we evaluated the intervention sites (North and South) separately...
December 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29061072/perinatally-hiv-infected-youths-after-transition-from-pediatric-to-adult-care-a-single-center-experience-from-northern-italy
#15
Ilaria Izzo, Eugenia Quiros-Roldan, Barbara Saccani, Erika Chiari, Salvatore Casari, Emanuele Focà, Maria Chiara Pezzoli, Maria Antonia Forleo, Andrea Bonito, Raffaele Badolato, Laura Dotta, Francesco Castelli
With the development of combination antiretroviral therapy (cART), the first generation of perinatally HIV-infected children has reached young adulthood. A retrospective study was conducted on perinatally HIV-infected young adults after transition to adult care in Brescia (Northern Italy). Twenty-four patients were transferred to Infectious Disease outpatient Clinic from Pediatric Clinic between 2004 and 2016. Median age at transition was 18 years. 37.5% were male, and 75% were Italian. Median CD4(+) T-cell count was 534 cell/μL, and 9/24 presented detectable HIV-RNA at the time of transition...
November 17, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29057084/changes-in-the-haematological-parameters-of-hiv-1-infected-children-at-6-and-12-months-of-antiretroviral-therapy-in-a-large-clinic-cohort-north-central-nigeria
#16
EDITORIAL
Augustine O Ebonyi, Stephen Oguche, Martha O Ochoga, Oche O Agbaji, Joseph A Anejo-Okopi, Isaac O Abah, Prosper I Okonkwo, John A Idoko
BACKGROUND: Prior to commencing antiretroviral therapy (ART), haematological abnormalities are a common occurrence in individuals diagnosed with human immunodeficiency virus (HIV). In the course of receiving ART, these abnormalities usually improve. We determined the prevalence of haematological abnormalities in children diagnosed with HIV-1 and the changes in haematological parameters that occur after 6 and 12 months of being on ART. METHODS: A cross-sectional study of HIV-1 infected children aged 2 months to 15 years, between July 2005 and March 2013, at the paediatric HIV clinic of the Jos University Teaching Hospital, Jos...
October 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/29052340/absence-of-neurocognitive-disadvantage-associated-with-paediatric-hiv-subtype-a-infection-in-children-on-antiretroviral-therapy
#17
Paul Bangirana, Theodore D Ruel, Michael J Boivin, Satish K Pillai, Leila B Giron, Alla Sikorskii, Asish Banik, Jane Achan
INTRODUCTION: Infection with HIV subtype A has been associated with poorer neurocognitive outcomes compared to HIV subtype D in Ugandan children not eligible for antiretroviral therapy (ART). In this study, we sought to determine whether subtype-specific differences are also observed among children receiving ART. MATERIALS AND METHODS: Children were recruited from a clinical trial in which they were randomized to receive either lopinavir (LPV)- or non-nucleoside reverse transcriptase inhibitor (NNRTI)- based ART (NCT00978068)...
October 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29039686/prevention-and-treatment-of-hiv-infection-in-neonates-evidence-base-for-existing-who-dosing-recommendations-and-implementation-considerations
#18
Diana F Clarke, Martina Penazzato, Edmund Capparelli, Tim R Cressey, George Siberry, Nandita Sugandhi, Mark Mirochnick
Antiretroviral drugs are used in neonates for prevention and treatment of HIV infection. Use of antiretrovirals to prevent perinatal HIV transmission is well established. Early identification of neonates infected with HIV and rapid initiation of combination antiretroviral treatment during the neonatal period is now recommended by WHO and DHHS. However, few antiretrovirals are available in formulations suitable for neonates and there are limited safety and pharmacokinetic data for most antiretrovirals in neonates...
October 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29029056/time-to-switch-to-second-line-antiretroviral-therapy-in-children-with-hiv-in-europe-and-thailand
#19
Intira Jeannie Collins
No abstract text is available yet for this article.
September 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28988435/triple-therapy-of-vincristine-bleomycin-and-etoposide-for-children-with-kaposi-sarcoma-results-of-a-study-in-malawian-children
#20
Marita Macken, Helen Dale, Dominic Moyo, Eunice Chakmata, Sarita Depani, Trijn Israels, Dalida Niyrenda, Simon Bailey, George Chagaluka, Elizabeth M Molyneux
BACKGROUND: Kaposi sarcoma (KS) is the most common paediatric cancer in human immunodeficiency virus (HIV) endemic countries of sub-Saharan Africa, but there is little research on management and outcomes. METHODS: Children with KS at Queen Elizabeth Central Hospital, Blantyre, Malawi treated between August 2012 and March 2015 with six courses of vincristine, bleomycin and etoposide combination chemotherapy, including antiretroviral therapy (ART) if HIV infected, were studied and outcomes compared with previously reported results...
October 8, 2017: Pediatric Blood & Cancer
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