Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Perinatally HIV-Infected Children Fare Worse Over Time
JAMA Pediatrics; 2017 May; Nielan, et al
Older children who were HIV infected perinatally face an increased risk of viremia, immunosuppression, mortality, as well as Centers for Disease Control and Prevention stage B (CDC-B) and stage C (CDC-C) events, according to data gleaned from multicenter cohort studies. Investigators who analyzed data from the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1074 multicenter cohort studies found the following:
- Among 1,446 patients who had been infected perinatally, those aged 13-17 and 18-30 years had a viral load of 400 copies/ml or more for a longer period of time than participants between the ages of 7 and 12 years.
- Similarly, these older age groups spent more time with a CD4 cell count below 200/µL.
- Researchers also observed higher rates of CDC-B and CDC-C events, bacterial infections, and deaths at the lower CD4 cell counts.
Neilan AM, Karalius B, Patel K, et al. Association of risk of viremia, immunosuppression, serious clinical events, and mortality with increasing age in perinatally human immunodeficiency virus–infected youth. JAMA Pediatrics. 2017;171:450-460. doi:10.1001/jamapediatrics.2017.0141.