Prophylaxis against Pneumocystis carinii pneumonia among children with perinatally acquired human immunodeficiency virus infection in the United States

Article Abstract:

Testing all pregnant women for HIV infection can help identify infants who may become infected so they can be given prophylactic treatment to prevent Pneumocystis carinii pneumonia (PCP). Twelve percent of HIV-infected infants may develop PCP in their first year of life. Researchers reviewed the records of 300 HIV-infected children who had acquired the infection perinatally and had developed PCP. Three-quarters of the children were younger than one year. Only 30% of the children ever received PCP prophylaxis. Fourteen children began receiving prophylaxis one month or less before they developed PCP. Of the two-thirds who never received prophylaxis, 60 were not known to be HIV-infected at the time they developed PCP. Fifty-eight were diagnosed with HIV within one month before their PCP diagnosis. There was no indication that CD4 T cell counts were ever measured in many of these infants. The Centers for Disease Control and Prevention has issued revised guidelines so that these infants can be diagnosed more quickly so PCP prophylaxis can be given sooner.

Health aspects, Maternal-fetal exchange, Prevention

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Heterosexually transmitted human immunodeficiency virus infection among pregnant women in a rural Florida community

Article Abstract:

HIV-infected women in a rural community studied were most likely to have acquired the virus through heterosexual intercourse. Women are increasingly becoming infected with HIV, and while most of them live in large, urban areas, 27% now are from rural areas. Of 1,011 pregnant women from an agricultural area of Florida, 52 (5.1%) were found to be HIV-positive. The highest infection rate, 8.3%, was among non-Haitian, non-Hispanic black women. In urban areas, most HIV-infected women are intravenous drug users, but in this study only four, all of whom were HIV-negative, claimed to have ever injected drugs. Of the 43 crack cocaine users, however, 14 were HIV-positive. In addition to crack use, sex with more than two partners or a high risk partner and syphilis infection were all associated with HIV infection. Still, 21% of the HIV-infected women reported none of these risk factors. These findings may be useful in designing HIV awareness programs for rural areas.

Women, Risk factors, Diseases, HIV (Viruses), HIV, Disease transmission

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Pneumocystis carinii pneumonia among US children with perinatally acquired HIV infection

Article Abstract:

The incidence of Pneumocystis carinii pneumonia (PCP) may be high among young children with HIV infection acquired from their mother. Early diagnosis of HIV infection in children would allow for treatment to prevent PCP. Among 3,665 children aged from birth to 12 years old who acquired HIV infection from their mothers, 37% developed PCP. More than half of the children with PCP developed the infection between three and six months of age. Of 275 HIV-positive children with PCP reported in a special surveillance study, 64% were diagnosed with PCP as their first or only AIDS-defining condition. Forty-four percent had not been tested for HIV infection before the development of PCP. The children survived an estimated average of 19 months after diagnosis with PCP.

Diagnosis

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