Predicting risk of Pneumocystis carinii pneumonia in human immunodeficiency virus-infected children

Article Abstract:

Pneumocystis carinii pneumonia (PCP) is an opportunistic infection of the lung caused by the protozoan-like organism P. carinii, and is characterized by slight fever, cough, and rapid and difficult breathing. PCP is a common complication of human immunodeficiency virus (HIV) infection, which causes AIDS. It affects more than 75 percent of HIV-infected adults and causes death in 20 percent of adult patients during the first P. carinii infection. Many HIV-infected infants die within one month after being diagnosed with PCP. The aerosol form of the drug pentamidine and the oral antibiotics trimethoprim/sulfamethoxazole were shown to be effective against PCP. Treatment to prevent the development of PCP can be started in high-risk adult patients with less than 200 million CD4 cells, a type of immune cell that decreases in HIV infection. The factors used to identify HIV-infected children at high risk of developing PCP have not been determined. Risk factors for PCP in HIV-infected children were assessed by review of the medical charts of 13 infants infected with HIV at birth and children with PCP. The results showed that PCP was more prevalent among infants less than 12 months of age regardless of normal CD4 numbers. Symptoms of HIV infection were evident before the development of PCP in 12 of 13 children. In this patient group, low levels of the immune protein immunoglobulin G (IgG) and decreased numbers of CD4 cells may also serve as indicators of high risk of PCP. The findings indicate that preventive treatment of PCP should be given to infants less than 12 months of age with symptoms of HIV infection, and older children with less than 300 million CD4 cells per liter. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Risk factors, Pneumocystis carinii pneumonia, Opportunistic infections

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Tuberculosis in human immunodeficiency virus-infected children: a family infection

Article Abstract:

The incidence of tuberculosis (TB) is increasing among inner-city children infected with HIV and their families. A worldwide resurgence of TB has occurred as a result of the HIV epidemic. A study examined the incidence of TB among 60 families with children who were infected with HIV. Of seven children from four different families who were diagnosed with TB, four were HIV-positive, three were HIV-negative seroreverters and one was an HIV-negative sibling of an HIV-positive child. The children diagnosed with TB were between 15 months and seven years old. Six of the children had been exposed to TB by an HIV-positive parent suffering from TB. These parents were intravenous drug users, homeless, or non-compliant with their medical treatment protocol. One child suffering from multiple-drug resistant TB died from complications of TB and HIV infection.

Disease transmission, Tuberculosis, Tuberculosis in children, Pediatric respiratory diseases

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Response of human immunodeficiency virus-exposed and -infected infants to Haemophilus influenzae type b conjugate vaccine

Article Abstract:

The immune system of HIV-infected infants may not respond as well as HIV-exposed but uninfected infants to initial immunizations against Haemophilus influenzae type b (Hib). Researchers compared the immune responses of HIV-infected to HIV-exposed infants to the primary series of three Hib vaccines and to 15-month booster doses. Immune response to the primary Hib vaccine series was lower in HIV-infected infants, with 46% of HIV-infected infants responding compared to 79% of HIV-exposed infants. Immune responses were similar after the 15-month booster dose, suggesting that the primary series primed the HIV-infected immune system to respond.

Physiological aspects, Children, Immunization of children, Immunization, Hib vaccines

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