Morbidity and Mortality of a Cohort of Peruvian HIV-infected Children 2003-2012

Baker, Amira N.; Kolevic, Lenka; Bayer, Angela M.; Sim, Myung-Shin; Viani, Rolando M.; Deville, Jaime G.

dc.contributor.author	Baker, Amira N.
dc.contributor.author	Bayer, Angela M.
dc.contributor.author	Viani, Rolando M.
dc.contributor.author	Kolevic, Lenka
dc.contributor.author	Sim, Myung-Shin
dc.contributor.author	Deville, Jaime G.
dc.date.accessioned	2018-11-30T17:17:16Z
dc.date.available	2018-11-30T17:17:16Z
dc.date.issued	2018
dc.identifier.uri	https://hdl.handle.net/20.500.12866/4125
dc.description.abstract	BACKGROUND: Data on pediatric HIV in Peru are limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under the age of 18 years in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003 and 2012. Deidentified data were collected and analyzed. RESULTS: A total of 280 children were included: 50.0% (140/280) were male; 80.0% (224/280) lived in metropolitan Lima. Perinatal transmission was the mode of HIV infection in 91.4% (256/280) of children. Only 17% (32/191) of mothers were known to be HIV-infected at delivery; of these mothers, 41% (13/32) were receiving antiretroviral therapy at delivery, 72% (23/32) delivered by Cesarean section and 47% (15/32) of their infants received antiretroviral prophylaxis. Median age at HIV diagnosis for all children was 35.7 months (interquartile range 14.5-76.8 months), and 67% (143/213) had advanced disease (clinical stage C). After HIV diagnosis, the most frequent hospitalization discharge diagnoses were bacterial pneumonia, chronic malnutrition, diarrhea, anemia and tuberculosis. Twenty-four patients (8.6%) died at a median age of 77.4 months. CONCLUSIONS: Most cases of pediatric HIV were acquired via perinatal transmission; few mothers were diagnosed before delivery; and among mothers with known HIV status, PMTCT was suboptimal even after national PMTCT policy was implemented. Most children were diagnosed with advanced disease. These findings underscore the need for improving early pediatric HIV diagnosis and treatment, as well as PMTCT strategies.	en_US
dc.language.iso	eng
dc.publisher	Wolters Kluwer Health
dc.relation.ispartofseries	Pediatric Infectious Disease Journal
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	pediatric HIV	en_US
dc.subject	Peru	en_US
dc.subject	morbidity and mortality	en_US
dc.title	Morbidity and Mortality of a Cohort of Peruvian HIV-infected Children 2003-2012	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1097/INF.0000000000001865
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.03
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn	1532-0987