OBJECTIVE: To describe the natural history of vertically acquired human immunodeficiency virus (HIV) infection. DESIGN: This was a prospective follow-up study. SETTING: Ten centers of the European Collaborative Study participated. SUBJECTS: One hundred twenty-four HIV-infected children were born to women known to be infected at or before the time of delivery since 1986. MAIN OUTCOME MEASURES: Deaths, acquired immunodeficiency syndrome (AIDS), and HIV-related symptoms and signs were assessed. RESULTS: In this cohort, treatment before the onset of AIDS was not universal. Less than 10% of children were treated with Zidovudine or intravenous gamma globulin before 6 months of age, with a steady increase to about 40% after 3 years of life. An estimated 23% (95% confidence interval: 15% to 31%) of infected children develop AIDS before the age of 1 year, and nearly 40% (27% to 50%) by 4 years. Ten percent (5% to 16%) die before age 1 year and 28% (16% to 41%) before age 5 years. Twenty-four months after the AIDS diagnosis, an estimated 48% (36% to 70%) of the children are still alive. Although after the age of 1 year immunologic abnormalities became increasingly common, the proportion of infected children with significant HIV-related symptoms or signs declined. CONCLUSION: The progression of disease in this cohort of vertically infected children was not as fast as previously suggested, even though treatment was not widespread. Although infected children have a high risk of developing some manifestation of HIV infection early in life, serious HIV-related symptoms became less frequent with increasing age. This has important implications for health planning and care provision

Natural history of vertically acquired human immunodeficiency virus-1 infection. The European Collaborative Study

GIAQUINTO, CARLO;DE ROSSI, ANITA
1994

Abstract

OBJECTIVE: To describe the natural history of vertically acquired human immunodeficiency virus (HIV) infection. DESIGN: This was a prospective follow-up study. SETTING: Ten centers of the European Collaborative Study participated. SUBJECTS: One hundred twenty-four HIV-infected children were born to women known to be infected at or before the time of delivery since 1986. MAIN OUTCOME MEASURES: Deaths, acquired immunodeficiency syndrome (AIDS), and HIV-related symptoms and signs were assessed. RESULTS: In this cohort, treatment before the onset of AIDS was not universal. Less than 10% of children were treated with Zidovudine or intravenous gamma globulin before 6 months of age, with a steady increase to about 40% after 3 years of life. An estimated 23% (95% confidence interval: 15% to 31%) of infected children develop AIDS before the age of 1 year, and nearly 40% (27% to 50%) by 4 years. Ten percent (5% to 16%) die before age 1 year and 28% (16% to 41%) before age 5 years. Twenty-four months after the AIDS diagnosis, an estimated 48% (36% to 70%) of the children are still alive. Although after the age of 1 year immunologic abnormalities became increasingly common, the proportion of infected children with significant HIV-related symptoms or signs declined. CONCLUSION: The progression of disease in this cohort of vertically infected children was not as fast as previously suggested, even though treatment was not widespread. Although infected children have a high risk of developing some manifestation of HIV infection early in life, serious HIV-related symptoms became less frequent with increasing age. This has important implications for health planning and care provision
1994
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2517496
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