Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
AIDS IN THE PEDIATRIC POPULATION
AIDS: Etiology, Diagnosis, Treatment, and Prevention. Second Edition. DeVita VT Jr et al, eds. Philadelphia, Lippincott, p. 339-51, 1988.. Unique Identifier : AIDSLINE ICDB/89650913 Falloon J; Eddy J; Roper M; Pizzo PA; Clinical Center, NIH, Bethesda, MD
Abstract:
Soon after AIDS was recognized in homosexual males and iv drug abusers, cases of an immunodeficiency with similar features were observed in children. AIDS in children is discussed, including routes of transmission, definition of AIDS in children, diagnosis of HIV infection in children, clinical manifestations, classification, biopsy and autopsy data, laboratory findings, prognosis, management and therapy, and prevention. Because most children are infected in utero or perinatally, HIV infection is an illness of young children, with 50% of children with AIDS being diagnosed during the first year of life and 82% by 3 yr of age. HIV infection in early infancy must be differentiated from other known immunodeficiencies, both congenital and acquired. Excessive reliance on serodiagnosis may be misleading. Manifestations of HIV infection are varied as in adults; they include nonspecific manifestations bacterial infections, encephalopathy, lymphocytic interstitial pneumonitis, opportunistic infections, and malignancies. The unique feature of the immunologic evaluation in HIV-infected children is the frequency of normal values in the face of severe illness. The current mainstay of therapy of HIV-infected children remains close observation and good general medical and supportive care, with prompt therapy for bacterial infections and treatable opportunistic infections. As in adults, adverse reactions to drugs are common. Nutrition can be a serious problem, and some children require iv hyperalimentation. The most widely administered therapy in symptomatic HIV-infected children is iv immunoglobin; firm research support for this approach does not exist. The use of antiretroviral agents in infants and children has lagged significantly behind their use in adults. Phase I studies of azidothymidine are nearing completion. Prevention of future HIV infection in children requires control of the infection in the adult population, particularly in women of childbearing age. (129 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/DIAGNOSIS/ THERAPY/*TRANSMISSION AIDS Serodiagnosis Child Human HIV/*PATHOGENICITY Infant, Newborn Male Maternal-Fetal Exchange Opportunistic Infections/COMPLICATIONS Pregnancy Pregnancy Complications, Infectious Prognosis Risk Factors MONOGRAPH REVIEW REVIEW, TUTORIAL
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
