AEGiS-15IAC: Asymptomatic, untreated perinatal HIV infection over 21 years after birth. An unique report, and psycho-sociological implications.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Asymptomatic, untreated perinatal HIV infection over 21 years after birth. An unique report, and psycho-sociological implications.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10227)

Manfredi R
Infectious Diseases, University of Bologna, Bologna, Italy

BACKGROUND: Also perinatal HIV infection may have a non-progressive course. However,a 21-year-long asymptomatic congenital HIV infection was never reported. Case report: Our patient (p) was born in October 1982 to a drug user mother,and identified as HIV-infected concurrently with her mother in 1984. Vertical HIV transmission was confirmed,by exclusion of other risk factors: administration of blood derivatives,or sexual abuse. Since birth,our p had an uneventful childhood,with regular achievement of all developmental milestones,save a slight delay in menarche presentation (at the age of 15). At the present 21 year-4 month age,her height is 164 cm,and body weight is 53 Kg. No HIV-associated signs-symptoms became apparent throughout the entire follow-up,save a migrant micropolyadenopathy. Laboratory evaluation,performed at least quarterly,did not show notable modifications,save physiological changes of the leukocyte differential,moving into adult age. In particular, CD4 count never falled<612 cells/muL,and viremia had its peak at the age of 12 (4.09 Log10 HIV-RNA copies/mL). Clinical-laboratory markers of HIV infection pose our p at stage A-1 (CDC,1994). Monthly iv Ig were administered until the age of 14 (when our p became aware of HIV infection),but no antiretroviral therapy was prescribed.

CONCLUSION: Simple survival beyond adolescence remains rare among p vertically-infected in the pre-therapy era,while a non-progressive congenital infection lasting asymptomatically until adult age has not comparable literature evidences. A stable,almost completely symptom-free HIV disease with a steadily favorable immunologic picture,low viral load,and no need of anti-HIV therapy after over 21 years since birth,makes our report unique. Such a long perinatal HIV course raises relevant questions,about laboratory evaluation,anti-HIV therapy,and psychosocial implications. The natural history of non-progressive HIV infection from infancy into adult age and its correlates,needs further investigation

Keywords: AEGIS, HIV Infections, Acquired Immunodeficiency Syndrome, Disease Transmission, Vertical, Viral Load, HIV Seropositivity, Risk Factors, Viremia, Adult, Female, Humans, transmission, organization & administration, methods

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C10227