Long-term follow-up of HIV-seropositive children

P. A. Tovo, M. De Martino, C. Gabiano, L. Galli, G. Ferraris, C. Giaquinto, G. Castelli Gattinara, S. Garetto, A. Vierucci, P. Marchisio, G. V. Zuccotti, C. Fundarò, M. Duse, D. Caselli, A. De Maria, A. Plebani, C. Timpano, M. Lanari, M. Stegagno, M. RuggeriG. Gotta, L. Lipreri, M. Cellini, P. Osimani, D. Loriano, G. Benaglia, D. De Mattia, G. L. Forni, A. Romano, A. Antonellini, C. Pintor, R. Consolini, A. Mazza, A. Micco, A. Guarino, M. G. Marazzi, M. T. Cecchi, C. Di Bari, C. Dessì, T. Bezzi, S. Bionda, G. Dell'Erba, L. Battisti, C. Salvatore, M. Sticca, E. Anastasio, M. Masi, C. Magnani, L. Tarallo, G. Gambaretto, S. Catania, A. Pellegatta, A. Todeschini, F. Baldi, C. Nasi, E. Bresciani, L. Tasso, M. Molesini, P. G. Chiriacò, C. Ruggeri, C. Stucchi, F. Resta, G. Sabatino, E. Delle Nogare, U. Tondo, D. Tommasi, A. Meo, I. Contardi, V. Portelli

Research output: Contribution to journalArticlepeer-review

Abstract

Of the 4720 children enrolled in the Italian Register, 4554 were born to seropositive mothers. Of the latter, at the latest update 2989 (65.6%) had seroreverted, 440 (9.7%) were in indeterminate infection status, while 1125 (24.7%) were infected. Among these, 382 died of HIV-associated illnesses. The median age of those still alive was 82.5 months (range 1.4-192.8 months). The last survival curve highlighted an improvement in survival probability (51% at 130 months). The causes of death differed between infants and older children, with a higher proportion of Pneumocystis carinii pneumonia and cytomegalovirus (CMV) in the former. Only a fraction of infected children (<3%) become long-term non-progressors (LTNPs). Immunological and clinical deterioration may occur at any age and in any child, including LTNPs. A targeted analysis revealed a poor prognostic indication of the clinical and immunological categories of the current CDC classification system for HIV infection in children. Both infected and uninfected exposed children are at high risk of separation from their family due to either parents' death or drug use. Given the high proportion of intravenous drug users among HIV- positive mothers, about three-quarters had hepatitis C virus (HCV) co- infection, and some of their children who escaped infection with HIV acquired HCV. An increasing proportion of HIV-infected children are approaching adolescence. This raises important new problems, such as when and how to communicate the diagnosis to these children, who need adequate psychological support to face the impact of knowing they are carriers of such an infection.

Original languageEnglish
Pages (from-to)344-350
Number of pages7
JournalPrenatal and Neonatal Medicine
Volume4
Issue number5
Publication statusPublished - 1999

Keywords

  • Antiretroviral therapy
  • Children
  • Disease progression
  • Follow-up
  • HIV

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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