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https://www.readbyqxmd.com/read/28419200/switching-to-efavirenz-versus-remaining-on-ritonavir-boosted-lopinavir-in-hiv-infected-children-exposed-to-nevirapine-long-term-outcomes-of-a-randomized-trial
#1
Pamela M Murnane, Renate Strehlau, Stephanie Shiau, Faeezah Patel, Ndileke Mbete, Gillian Hunt, Elaine J Abrams, Ashraf Coovadia, Louise Kuhn
Background: We previously demonstrated the non-inferiority of switching to efavirenz (EFV) versus remaining on ritonavir-boosted lopinavir (LPV/r) for virologic control in HIV-infected children exposed to nevirapine (NVP) for prevention of mother-to-child transmission. Here we assess outcomes up to four years post-randomization. Methods: From 2010-2013, 298 NVP-exposed HIV-infected children ≥3 years of age were randomized to switch to EFV or remain on LPV/r in Johannesburg, South Africa (Clinicaltrials...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28406952/individual-and-contextual-factors-associated-with-appropriate-healthcare-seeking-behavior-among-febrile-children-in-tanzania
#2
Juma Adinan, Damian J Damian, Neema R Mosha, Innocent B Mboya, Redempta Mamseri, Sia E Msuya
INTRODUCTION: Fever in malaria endemic areas, has been shown to strongly predict malaria infection and is a key symptom influencing malaria treatment. WHO recommended confirmation testing for Plasmodium spp. before initiation of antimalarials due to increased evidence of the decrease of morbidity and mortality from malaria, decreased malaria associated fever, and increased evidence of high prevalence of non-malaria fever. To immediately diagnose and promptly offer appropriate management, caretakers of children with fever should seek care where these services can be offered; in health facilities...
2017: PloS One
https://www.readbyqxmd.com/read/28395844/effect-of-co-trimoxazole-on-mortality-in-hiv-exposed-but-uninfected-children-in-botswana-the-mpepu-study-a-double-blind-randomised-placebo-controlled-trial
#3
Shahin Lockman, Michael Hughes, Kate Powis, Gbolahan Ajibola, Kara Bennett, Sikhulile Moyo, Erik van Widenfelt, Jean Leidner, Kenneth McIntosh, Loeto Mazhani, Joseph Makhema, Max Essex, Roger Shapiro
BACKGROUND: Co-trimoxazole prophylaxis reduces mortality among HIV-infected children, but efficacy in HIV-exposed but uninfected (HEU) children in a non-malarial, low-breastfeeding setting with a low risk of mother-to-child transmission of HIV is unclear. METHODS: HEU children in Botswana were randomly assigned to receive co-trimoxazole (100 mg/20 mg once daily until age 6 months and 200 mg/40 mg once daily thereafter) or placebo from age 14-34 days to age 15 months...
May 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28359325/early-versus-late-bcg-vaccination-in-hiv-1-exposed-infants-in-uganda-study-protocol-for-a-randomized-controlled-trial
#4
Victoria Nankabirwa, James K Tumwine, Olive Namugga, Thorkild Tylleskär, Grace Ndeezi, Bjarne Robberstad, Mihai G Netea, Halvor Sommerfelt
BACKGROUND: Bacillus Calmette-Guérin (BCG) vaccination may have nonspecific effects, i.e., effects on childhood morbidity and mortality that go beyond its effect on the risk of childhood tuberculosis (TB). Though the available scientific literature is mostly from observational studies, and is fraught with controversy, BCG vaccination at birth may protect infants in high-mortality populations against serious infections other than TB. Yet, other studies indicate that giving BCG later in infancy may modify immune responses to non-TB antigens and potentially enhance immunity, potentially also against tuberculosis (TB)...
March 31, 2017: Trials
https://www.readbyqxmd.com/read/28350802/impact-of-lopinavir-ritonavir-exposure-in-hiv-1-infected-children-and-adolescents-in-madrid-spain-during-2000-2014
#5
Patricia Rojas Sánchez, Luis Prieto, Santiago Jiménez De Ory, Elisa Fernández Cooke, Maria Luisa Navarro, José Tomas Ramos, África Holguín
BACKGROUND: The most-used protease-inhibitor in children is Lopinavir-ritonavir (LPV/r), which provides durable suppression of viral load and increases CD4+T-counts. This study describes the virological outcome of the HIV-1-infected paediatric population exposed to LPV/r during 15 years in Spain. METHODOLOGY: Patients from the Madrid Cohort of HIV-1-infected-children and adolescents exposed to LPV/r as different line therapy during 2000-2014 were selected. The baseline epidemiological-clinical features, viral suppression, changes in CD4+T-CD8+T cell counts and drug susceptibility were recorded before and during LPV/r exposure...
2017: PloS One
https://www.readbyqxmd.com/read/28333295/drug-resistance-in-antiretroviral-naive-children-newly-diagnosed-with-hiv-1-in-manaus-amazonas
#6
Solange Dourado de Andrade, Meritxell Sabidó, Wuelton Marcelo Monteiro, Adele Schwartz Benzaken, Amilcar Tanuri
Objectives: To determine the prevalence of drug resistance mutations (DRM), the prevalence of drug susceptibility [transmitted drug resistance (TDR)] and the prevalence of HIV-1 variants among treatment-naive HIV-infected children in Manaus, Amazonas state, Brazil. Methods: Children born to HIV-infected mothers and diagnosed with HIV in an HIV reference service centre and with available pol sequence between 2010 and 2015 prior to antiretroviral initiation were included...
March 13, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28320796/effect-of-alcohol-consumption-and-psychosocial-stressors-on-preterm-and-small-for-gestational-age-births-in-hiv-infected-women-in-south-africa-a-cohort-study
#7
Ayesha Sania, Kirsty Brittain, Tamsin K Phillips, Allison Zerbe, Agnes Ronan, Landon Myer, Elaine J Abrams
OBJECTIVES: Psychosocial stressors such as depression and stress, intimate partner violence (IPV) and alcohol use have been linked to preterm and small-for-gestational-age (SGA) births in general populations. The prevalence of psychosocial stressors and alcohol abuse is high in many HIV-infected (HIV+) populations. Our objective was to evaluate the effects of psychosocial stressors and alcohol abuse on birth outcomes in HIV-infected women. METHODS: Antenatal depression and non-specific psychological distress, periconception IPV and alcohol consumption were measured during the second trimester among HIV+ women initiating antiretroviral treatment with efavirenz + emtricitibine + tenofovir in Cape Town, South Africa...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28145162/early-use-of-corticosteroids-in-infants-with-a-clinical-diagnosis-of-pneumocystis-jiroveci-pneumonia-in-malawi-a-double-blind-randomised-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Laura Newberry, Bernadette O'Hare, Neil Kennedy, Andrew Selman, Sofia Omar, Pamela Dawson, Kim Stevenson, Yo Nishihara, Samantha Lissauer, Elizabeth Molyneux
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in infants with vertically acquired HIV infection and the most common cause of death in HIV-infected infants. OBJECTIVES: To determine whether early administration of adjuvant corticosteroids in addition to standard treatment reduces mortality in infants with vertically acquired HIV and clinically diagnosed PJP when co-infection with cytomegalovirus and other pathogens cannot be excluded...
May 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28079828/vaccination-with-10-valent-pneumococcal-conjugate-vaccine-in-infants-according-to-hiv-status
#9
RANDOMIZED CONTROLLED TRIAL
Shabir A Madhi, Anthonet Koen, Lisa Jose, Nadia van Niekerk, Peter V Adrian, Clare Cutland, Nancy François, Javier Ruiz-Guiñazú, Juan-Pablo Yarzabal, Marta Moreira, Dorota Borys, Lode Schuerman
BACKGROUND: Phase III, open-label, single-center, controlled study in South Africa (ClinicalTrials.gov: NCT00829010) to evaluate immunogenicity, reactogenicity, and safety of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in human immunodeficiency virus (HIV)-infected (HIV+), HIV-exposed-uninfected (HEU), and HIV-unexposed-uninfected (HUU) children. METHODS: Children stratified by HIV status received PHiD-CV primary vaccination (age 6/10/14 weeks; coadministered with routine childhood vaccines) and booster dose (age 9-10 months)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27856673/associations-of-memory-and-executive-functioning-with-academic-and-adaptive-functioning-among-youth-with-perinatal-hiv-exposure-and-or-infection
#10
Patricia A Sirois, Miriam C Chernoff, Kathleen M Malee, Patricia A Garvie, Lynnette L Harris, Paige L Williams, Steven P Woods, Molly L Nozyce, Betsy L Kammerer, Cenk Yildirim, Sharon L Nichols
BACKGROUND: Perinatally acquired HIV (PHIV) confers risk for neurocognitive impairment, which potentially affects school performance and functional independence of infected children. In this study, we examined the associations of 2 key neurocognitive domains, memory and executive function (EF), with academic and adaptive skills among youth with PHIV and perinatally HIV-exposed but uninfected (PHEU) youth. METHODS: Participants ages 9 to <19 years enrolled in the Pediatric HIV/AIDS Cohort Study's Memory and Executive Functioning Study completed standardized measures of reading and math...
December 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27856672/executive-functioning-in-children-and-adolescents-with-perinatal-hiv-infection-and-perinatal-hiv-exposure
#11
Sharon L Nichols, Miriam C Chernoff, Kathleen M Malee, Patricia A Sirois, Steven P Woods, Paige L Williams, Cenk Yildirim, Dean Delis, Betsy Kammerer
BACKGROUND: Executive functions (EFs) are critical for management of life activities, but few studies have evaluated EFs in children and adolescents with perinatally acquired HIV (PHIV), who are at risk for problems in academics, behavior, and medication adherence. We compared EFs in youth with PHIV and in perinatally HIV-exposed but uninfected (PHEU) youth. METHODS: Four Delis-Kaplan Executive Function System (D-KEFS) subtests were administered to 173 youth with PHIV and 85 PHEU youth, aged 9 to <19 years, who were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Memory and Executive Functioning Study...
December 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27836020/high-levels-of-pre-treatment-hiv-drug-resistance-and-treatment-failure-in-nigerian-children
#12
Ragna S Boerma, T Sonia Boender, Kim C E Sigaloff, Tobias F Rinke de Wit, Michael Boele van Hensbroek, Nicaise Ndembi, Titilope Adeyemo, Edamisan O Temiye, Akin Osibogun, Pascale Ondoa, Job C Calis, Alani Sulaimon Akanmu
INTRODUCTION: Pre-treatment HIV drug resistance (PDR) is an increasing problem in sub-Saharan Africa. Children are an especially vulnerable population to develop PDR given that paediatric second-line treatment options are limited. Although monitoring of PDR is important, data on the paediatric prevalence in sub-Saharan Africa and its consequences for treatment outcomes are scarce. We designed a prospective paediatric cohort study to document the prevalence of PDR and its effect on subsequent treatment failure in Nigeria, the country with the second highest number of HIV-infected children in the world...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27798548/growth-at-2-years-of-age-in-hiv-exposed-uninfected-children-in-the-united-states-by-trimester-of-maternal-antiretroviral-initiation
#13
Denise L Jacobson, Kunjal Patel, Paige L Williams, Mitchell E Geffner, George K Siberry, Linda A DiMeglio, Marilyn J Crain, Ayesha Mirza, Janet S Chen, Elizabeth McFarland, Deborah Kacanek, Margarita Silio, Kenneth Rich, William Borkowsky, Russell B Van Dyke, Tracie L Miller
BACKGROUND: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at 1 year of age in HIV-exposed uninfected (HEU) US children. METHODS: We studied 509 HEU children in the US-based Surveillance Monitoring of Antiretroviral Therapy Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART initiators)...
February 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27676257/pre-exposure-prophylaxis-use-by-breastfeeding-hiv-uninfected-women-a-prospective-short-term-study-of-antiretroviral-excretion-in-breast-milk-and-infant-absorption
#14
Kenneth K Mugwanya, Craig W Hendrix, Nelly R Mugo, Mark Marzinke, Elly T Katabira, Kenneth Ngure, Nulu B Semiyaga, Grace John-Stewart, Timothy R Muwonge, Gabriel Muthuri, Andy Stergachis, Connie L Celum, Jared M Baeten
BACKGROUND: As pre-exposure prophylaxis (PrEP) becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women. METHODS AND FINDINGS: We conducted a prospective short-term, open-label study of daily oral emtricitabine-tenofovir disoproxil fumarate PrEP among 50 HIV-uninfected breastfeeding African mother-infant pairs between 1-24 wk postpartum (ClinicalTrials...
September 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27599655/rethinking-the-risk-benefit-ratio-of-efavirenz-in-hiv-infected-children
#15
REVIEW
Lisa Van de Wijer, Arnt F A Schellekens, David M Burger, Judith R Homberg, Quirijn de Mast, Andre J A M van der Ven
The non-nucleoside reverse transcriptase inhibitor efavirenz is part of the WHO guidelines for preferred first-line treatment of HIV-1-infected adults, pregnant and lactating women, and children. Efavirenz is well known to cause CNS toxicity. Although good data for CNS toxicity are available for adults, the opposite is true for children. Paediatric studies on this topic frequently suffer from small sample sizes or absence of thorough neuropsychiatric assessments. In this Personal View, we focus on two knowledge gaps of CNS toxicity of efavirenz in children...
May 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27595698/the-aetiology-of-diarrhoea-pneumonia-and-respiratory-colonization-of-hiv-exposed-infants-randomized-to-breast-or-formula-feeding
#16
RANDOMIZED CONTROLLED TRIAL
Rebecca M Zash, Roger L Shapiro, Jean Leidner, Carolyn Wester, Alexander J McAdam, Richard L Hodinka, Ibou Thior, Claire Moffat, Joseph Makhema, Kenneth McIntosh, Max Essex, Shahin Lockman
BACKGROUND: Diarrhoea and pneumonia are common causes of childhood death in sub-Saharan Africa but there are few studies describing specific pathogens. OBJECTIVES: The study aimed to describe the pathogens associated with diarrhoea, pneumonia and oropharyngeal colonization in children born to HIV-infected women (HIV-exposed infants). METHODS: The Mashi Study randomized 1200 HIV-infected women and their infants to breastfeed for 6 months with ZDV prophylaxis or formula-feed with 4 weeks of ZDV...
August 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27406638/randomised-controlled-trial-testing-the-effect-of-cotrimoxazole-prophylaxis-on-morbidity-and-mortality-outcomes-in-breastfed-hiv-exposed-uninfected-infants-study-protocol
#17
Anna Coutsoudis, Brodie Daniels, Eshia Moodley-Govender, Noluthando Ngomane, Linda Zako, Elizabeth Spooner, Photini Kiepiela, Shabashini Reddy, Louise Kuhn, Gita Ramjee
INTRODUCTION: No randomised controlled trial (RCT) has examined the efficacy of cotrimoxazole (CTX) prophylaxis in HIV-exposed uninfected (HEU) infants during the breastfeeding period, in this new era of effective prevention of mother-to-child transmission (PMTCT) prophylaxis. The efficacy of CTX prophylaxis has presently been demonstrated only in HIV-infected children. The absence of proven benefits in HEU breastfed infants associated with infectious diseases justifies an RCT as proposed...
2016: BMJ Open
https://www.readbyqxmd.com/read/27077612/the-aetiology-of-diarrhoea-pneumonia-and-respiratory-colonization-of-hiv-exposed-infants-randomized-to-breast-or-formula-feeding
#18
Rebecca M Zash, Roger L Shapiro, Jean Leidner, Carolyn Wester, Alexander J McAdam, Richard L Hodinka, Ibou Thior, Claire Moffat, Joseph Makhema, Kenneth McIntosh, Max Essex, Shahin Lockman
BACKGROUND: Diarrhoea and pneumonia are common causes of childhood death in sub-Saharan Africa but there are few studies describing specific pathogens. OBJECTIVES: The study aimed to describe the pathogens associated with diarrhoea, pneumonia and oropharyngeal colonization in children born to HIV-infected women (HIV-exposed infants). METHODS: The Mashi Study randomized 1200 HIV-infected women and their infants to breastfeed for 6 months with ZDV prophylaxis or formula-feed with 4 weeks of ZDV...
January 29, 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27015798/missed-opportunities-of-inclusion-in-a-cohort-of-hiv-infected-children-to-initiate-antiretroviral-treatment-before-the-age-of-two-in-west-africa-2011-to-2013
#19
Désiré L Dahourou, Madeleine Amorissani-Folquet, Malik Coulibaly, Divine Avit-Edi, Nicolas Meda, Marguerite Timite-Konan, Vic Arendt, Diarra Ye, Clarisse Amani-Bosse, Roger Salamon, Philippe Lepage, Valériane Leroy
INTRODUCTION: The World Health Organization (WHO) 2010 guidelines recommended to treat all HIV-infected children less than two years of age. We described the inclusion process and its correlates of HIV-infected children initiated on early antiretroviral therapy (EART) at less than two years of age in Abidjan, Côte d'Ivoire, and Ouagadougou, Burkina Faso. METHODS: All children with HIV-1 infection confirmed with a DNA PCR test of a blood sample, aged less than two years, living at a distance less than two hours from the centres and whose parents (or mother if she was the only legal guardian or the legal caregiver if parents were not alive) agreed to participate in the MONOD ANRS 12206 project were included in a cohort to receive EART based on lopinavir/r...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/26979496/the-enduring-impact-of-violence-against-children
#20
Susan D Hillis, James A Mercy, Janet R Saul
More than one billion children - half of all children in the world - are exposed to violence every year. The violence children are exposed to includes both direct experiences of physical, sexual, and emotional abuse, as well as indirectly witnessing violence in their homes, schools, and communities. What these various forms of violence share, based on a review of the literature, is their enduring potential for life-long consequences. These consequences include increases in the risks of injury, HIV, sexually transmitted infections, mental health problems, reproductive health problems, and non-communicable diseases, including cardiovascular disease, cancer, chronic lung disease, and diabetes...
March 16, 2016: Psychology, Health & Medicine
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