Document Detail


The early natural history of vertically transmitted HIV-1 infection in African children from Durban, South Africa.
MedLine Citation:
PMID:  9924555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Forty-eight children with vertically transmitted HIV-1 infection and 93 uninfected infants were followed up at regular intervals from birth for a mean of 26 months. They were examined physically, growth and development were assessed and illnesses recorded. Seventy per cent of infected infants were symptomatic by 6 months. Relative risks in the infected infants were highest for lymphadenopathy (4.56; CI 2.7-7.7), failure to thrive (4.48; 2.57-7.81), and neurological abnormalities (3.32; 1.9-5.58). The most frequent findings were diarrhoea (78%), pneumonia (76%) and lymphadenopathy (70%). Thrush and pneumonia occurred early but declined over time, whereas diarrhoea and neurological abnormalities occurred later and increased in frequency. A diagnosis of AIDS was made in 44% of infected infants by 12 months of age. Mortality in infected infants was 35.4%, and 76% of deaths occurred within the 1st year. About two-thirds of HIV-infected infants survived into early childhood. In South African children with vertically acquired HIV-1 infection the onset of disease is early and deterioration to AIDS and death are rapid. Infected infants can be easily recognized clinically, the majority by 6 months of age.
48 children with vertically acquired HIV-1 infection and 93 uninfected infants were followed up at regular intervals from birth for a mean period of 26 months. They were examined physically, had their growth and development assessed, and illnesses recorded. 70% of HIV-infected infants were symptomatic by age 6 months. Relative risks of specific signs of disease in the infected infants were highest for lymphadenopathy, failure to thrive, and neurological abnormalities. The most frequent findings were diarrhea (78%), pneumonia (76%), and lymphadenopathy (70%). Thrush and pneumonia occurred early, but declined over time, while diarrhea and neurological abnormalities occurred later and increased in frequency. AIDS was diagnosed in 44% of infected infants by age 12 months. HIV mortality in infected infants was 35.4%, with 76% of deaths occurring during the first year of life. About two-thirds of HIV-infected infants survived into early childhood.
Authors:
R Bobat; D Moodley; A Coutsoudis; H Coovadia; E Gouws
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of tropical paediatrics     Volume:  18     ISSN:  0272-4936     ISO Abbreviation:  Ann Trop Paediatr     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1999-02-08     Completed Date:  1999-02-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8210625     Medline TA:  Ann Trop Paediatr     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  187-96     Citation Subset:  IM; J; X    
Affiliation:
Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, South Africa.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / diagnosis,  mortality
Child Welfare
Child, Preschool
Disease Progression
HIV Infections / transmission*
HIV-1*
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical*
Risk Factors
South Africa / epidemiology

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