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Journal of Human Virology 1999
Topics: Acquired Immunodeficiency Syndrome; Breast Feeding; Child; Global Health; Health Policy; Humans; Infectious Disease Transmission, Vertical
PubMed: 10200593
DOI: No ID Found -
Children Today 1988
Topics: Acquired Immunodeficiency Syndrome; Child; Child, Preschool; Cross-Sectional Studies; Humans; Infant; Infant, Newborn; Risk Factors; United States
PubMed: 3261230
DOI: No ID Found -
Pediatrics Mar 2019
Review
Topics: Acquired Immunodeficiency Syndrome; Antiretroviral Therapy, Highly Active; Gift Giving; Humans
PubMed: 30709925
DOI: 10.1542/peds.2018-2802 -
Social Work in Health Care 1996Pediatric AIDS is a continuing problem because of maternal transmission. Medical management is often complicated by the loss of one or both parents and adverse home...
Pediatric AIDS is a continuing problem because of maternal transmission. Medical management is often complicated by the loss of one or both parents and adverse home environments. This study explores the cost of inpatient and clinic care of children admitted with AIDS in 1988 or 1989 at Mount Sinai Medical Center in New York City, and also examines the social severity of the cases. Blue Shield allowances were used to price clinic visits and tests, and prices in a drug trade publication were used to determine medication costs. Inpatient costs calculated per person-month at risk amounted to $48,000 per year. Costs per person-month of the clinic care averaged $461 (38% of which was for drugs), annualized to around $5,500. These costs are higher than those shown by previous studies. A few cases requiring intensive inpatient services accounted for a large percentage of costs. The social severity analysis, based on the family environment at first admission and later, revealed that households were often stressed by chronic illnesses, drug abuse, marital problems and poor residential quality. Given the circumstances in which pediatric AIDS develops, the activities of social workers to strengthen families are essential to facilitating compliance, maintaining health and minimizing use of the hospital.
Topics: Acquired Immunodeficiency Syndrome; Child; Child, Hospitalized; Cost of Illness; Family; Health Care Costs; Humans; New York City; Retrospective Studies; Social Support
PubMed: 8807735
DOI: 10.1300/J010v22n04_01 -
ASDC Journal of Dentistry For Children 1991Few--if any--dental practitioners are unaware of the increasing changes occurring in dental and medical practices as a result of this deadly disease. (Review)
Review
Few--if any--dental practitioners are unaware of the increasing changes occurring in dental and medical practices as a result of this deadly disease.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Child; Child, Preschool; Female; Humans; Male; United States
PubMed: 1939807
DOI: No ID Found -
AIDS (London, England) Jul 1998To describe the natural history of somatic growth in HIV infection by constructing age-specific growth velocity norms and to assess specific prognostic information...
OBJECTIVE
To describe the natural history of somatic growth in HIV infection by constructing age-specific growth velocity norms and to assess specific prognostic information available using these norms.
DESIGN
Observations on 1338 HIV-infected children aged 3 months to 15 years who participated in one of four US clinical trials of pediatric anti-HIV therapies were pooled; baseline growth velocity data were obtained using the first 6 months of observation for each child.
METHODS
Distributions of physical growth velocities in HIV-infected children in the Pediatric AIDS Clinical Trials Group were computed. Statistical smoothing of growth histories was employed to derive velocity estimates, and quantile regression analysis of growth velocities was performed to allow comparisons of growth rates in age- and gender-heterogeneous cohorts in the context of HIV infection. The quantile regressions provide corrected z-scores for growth velocity that appropriately compare HIV-infected children with one another for the purpose of distinguishing more from less favorable prognoses.
RESULTS
Consistent deficits in growth velocity amongst HIV-infected children were revealed when compared with the Fels Institute velocity standards. Approximately 33% of height (and 20% of weight) age- and sex-corrected velocity measurements obtained in the first 6 months of clinical trial participation lay beneath the corresponding third percentiles of the Fels reference distributions, which are commonly regarded as critical indicators of growth failure. Proportional hazards regression tests indicated that both weight and height velocity contributed significant information on the risk of death among children with AIDS after adjusting for antiretroviral therapy received, CD4 cell counts, and age at trial enrollment. Comparing subjects who differ in initial weight velocity by one age- and sex-corrected SD, the relative hazard of death was 0.63 (95% confidence interval, 0.55-0.72; P < or = 0.0001) in favor of the child with greater weight velocity, controlling for antiretroviral therapy received, age and CD4 cell count at baseline. The analogous hazard ratio for height velocity was 0.68 (95% confidence interval, 0.57-0.79; P < or = 0.0001).
CONCLUSIONS
Suitably normalized growth velocities are informative and inexpensive criteria for pediatric AIDS prognosis; the growth velocity distributions presented will be useful for comparing growth effects of new therapeutic strategies to those of single and combination antiretrovirals employed for maintenance of pediatric HIV infection in the mid-1990s.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Anti-HIV Agents; Body Height; Body Weight; Child; Child, Preschool; Female; HIV Long-Term Survivors; Humans; Infant; Male; Models, Biological; Probability; Prognosis; Reverse Transcriptase Inhibitors
PubMed: 9708417
DOI: 10.1097/00002030-199811000-00019 -
Pediatric Neurology 1991Fourteen consecutive children (age range: 4 months to 11 years; median: 4 years) with acquired immunodeficiency syndrome (AIDS) were studied prospectively with cranial...
Fourteen consecutive children (age range: 4 months to 11 years; median: 4 years) with acquired immunodeficiency syndrome (AIDS) were studied prospectively with cranial magnetic resonance imaging (MRI) and unenhanced computed tomography (CT). In 4 children, human immunodeficiency virus infection was transfusion-related, while in 10, transplacental transmission occurred. Twelve children had abnormal neurologic examinations; of these, 10 had developmental delay and 2 were normal by developmental history and neurologic examination. Standardized neuropsychologic tests were given to all children; 5 were in the normal range and 9 demonstrated significant delays in verbal or motor/perceptual development. All children with abnormal neuropsychologic results were developmentally delayed; however, in 2 infants with normal neuropsychologic assessments, developmental delay and abnormal neurologic examinations were documented. Brain parenchymal volume loss (8 patients) and cervical lymphatic hypertrophy (4 patients) were demonstrated equally well by MRI and CT. CT alone demonstrated striatal-thalamic calcification (1 patient), whereas MRI alone demonstrated delayed myelination (1 patient). The extent of focal white matter lesions in 1 patient was demonstrated better by MRI than by CT. No intracranial mass lesions were demonstrated; however, significant correlations were found between peripheral volume loss imaged by either MRI or CT and both verbal and performance scores. In our small series, MRI offered no apparent advantage over CT in evaluating children with AIDS. We suggest that CT alone is sufficiently sensitive in evaluating pediatric AIDS-related brain abnormalities.
Topics: Acquired Immunodeficiency Syndrome; Brain; Brain Diseases; Child; Child Development; Child, Preschool; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Neurologic Examination; Tomography, X-Ray Computed
PubMed: 1764138
DOI: 10.1016/0887-8994(91)90066-t -
Texas Medicine Mar 1990For 9 years we have recognized HIV infection/AIDS as an unstoppable epidemic affecting infants, children, and adolescents as well as adults. Now we see the tremendous...
For 9 years we have recognized HIV infection/AIDS as an unstoppable epidemic affecting infants, children, and adolescents as well as adults. Now we see the tremendous impact of this disease on the health systems of this country. During these past 9 years, we have witnessed the transformation of the epidemic from one primarily affecting male homosexuals to one invading the average US family through heterosexual and vertical transmissions and through needle-sharing practices of intravenous drug abuse. It has been estimated that 2% to 3% of the HIV infection/AIDS cases involve the pediatric age group. If 1.5 million Americans have HIV infection by 1991, as predicted, we should anticipate 30,000 to 45,000 infected pediatric patients by the end of that year. What has been the impact of this epidemic on the health systems involved in care, prevention, and research of pediatric HIV infection/AIDS? This article investigates that question.
Topics: Acquired Immunodeficiency Syndrome; Child; Child, Preschool; Delivery of Health Care; Humans; Infant; Infant, Newborn; United States
PubMed: 2333637
DOI: No ID Found -
Obstetrics and Gynecology Clinics of... Sep 1990Infection with HIV results in a chronic, persistent infection that usually progresses slowly from an asymptomatic state to full-blown AIDS. AIDS remains a lethal disease... (Review)
Review
Infection with HIV results in a chronic, persistent infection that usually progresses slowly from an asymptomatic state to full-blown AIDS. AIDS remains a lethal disease with no effective cure. A great deal of information has been learned in the past decade, yet many questions remain unresolved. Much more research is needed into the conditions surrounding the perinatal transmission of HIV. Many women who give birth to a child with AIDS are themselves asymptomatic for HIV infection during pregnancy and at delivery; thus, routine voluntary prenatal HIV screening programs must be instituted in areas of high seroprevalence. Such screening programs must provide pretest and post-test counseling with consent and confidentiality. Seroprevalence studies conducted during the perinatal period or at birth using newborn blood samples will provide important epidemiologic data for further research investigations as well as continued estimates of the prevalence of HIV infection. Currently, there is no formal reporting system for HIV infection, only for the clinical expression of AIDS. There may be a need to develop a centralized reporting unit for HIV infection. As the epidemic continues and the true prevalence rates are determined, additional resources for public health care, housing, insurance, and foster care for children will be needed. The number of women who are infected is increasing at an alarming rate. Every opportunity to increase public awareness about the AIDS epidemic and modes of transmission must be exploited if we are to impact on the spread of HIV infection. Prospective studies of pregnant HIV-positive women and pediatric follow-up can provide a wealth of data about AIDS and disease progression in both the mother and the infant. Even if some children do not develop AIDS, the possibility of permanent effects of in utero exposure to the virus still exists. At what exact point in gestation does infection occur? Can infection be prevented or delayed with current chemotherapeutic protocols? Even if a cure or vaccine is developed in the near future, the impact of this deadly virus will have repercussions for many years to come.
Topics: Acquired Immunodeficiency Syndrome; Adult; Democratic Republic of the Congo; Female; HIV Seroprevalence; Hemophilia A; Homosexuality; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Complications; Prognosis; Risk Factors; Sexual Behavior; Transfusion Reaction
PubMed: 2247289
DOI: No ID Found -
AIDS (London, England) Aug 1990
Review
Topics: Acquired Immunodeficiency Syndrome; Americas; Deltaretrovirus Infections; Humans; Public Health
PubMed: 1702002
DOI: No ID Found