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Pneumocystis carinii pneumonia and cytomegalovirus infection in children with vertically acquired HIV infection
- Source :
- AIDS. 15:335-339
- Publication Year :
- 2001
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2001.
-
Abstract
- Objectives: The outcome of Pneumocystis carinii pneumonia (PCP) in HIV-infected infants is poor, and the role of cytomegalovirus (CMV) co-infection in the course and outcome of PCP is unclear. This study describes the prevalence, clinical characteristics, management and changes in survival over time of vertically HIV-infected infants developing PCP and/or CMV infection.Methods: Data on children with HIV, born in the UK and ireland and reported to the National Study of HIV in Pregnancy and Childhood, with PCP and/or CMV were combined with clinical information collected from reporting paediatricians.Results: By April 1998, 340 vertically HIV-infected children had been reported, of whom 93 had PCP and/or CMV, as their first AIDS indicator disease; 85 (91%) were infants. Among infants with PCP, 79% were born to mothers not diagnosed as HIV infected, and there was an independent and statistically significant association with breast-feeding, being black African, and developing CMV disease. Median survival after PCP and/or CMV was significantly better in those born between 1993 and 1998 compared with those born before 1993 (P = 0.009), and worse than after other AIDS diagnoses (P = 0.01). Infants with dual infection were more likely to be ventilated (P = 0.003) and receive corticosteroids (P = 0.002) than those with PCP alone.Conclusion: Although survival from PCP and CMV has improved over time, these remain serious and potentially fatal infections among infants in whom maternal HIV status is not recognized in pregnancy. Breast-feeding increases the risk of combined PCP and CMV infection, which is associated with severe disease. (C) 2001 Lippincott Williams & Wilkins.
- Subjects :
- Human cytomegalovirus
Pediatrics
medicine.medical_specialty
Opportunistic infection
Immunology
Congenital cytomegalovirus infection
Black People
HIV Infections
White People
Acquired immunodeficiency syndrome (AIDS)
Pregnancy
Risk Factors
Betaherpesvirinae
Humans
Immunology and Allergy
Medicine
Pregnancy Complications, Infectious
Sida
AIDS-Related Opportunistic Infections
biology
business.industry
Incidence
Pneumonia, Pneumocystis
Infant, Newborn
Infant
virus diseases
biology.organism_classification
medicine.disease
Infectious Disease Transmission, Vertical
United Kingdom
respiratory tract diseases
Black or African American
Survival Rate
Pneumonia
Breast Feeding
Infectious Diseases
Cytomegalovirus Infections
Female
business
Ireland
Breast feeding
Subjects
Details
- ISSN :
- 02699370
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- AIDS
- Accession number :
- edsair.doi.dedup.....7234cff3e3b9c124b258b8a193e8121f