Clinical Course of Perinatal HIV-infected Children in Chiangrai Prachanukroh Hospital
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Date
2011-03-10
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Buddhachinaraj Medical Journal
Abstract
Even though prevention of mother to child transmission (PMTCT) program has been implemented for 10 years,HIV-infected children are still found. This historical cohort study was conducted to describe disease manifestationand survival of perinatally HIV-infected children whom were born in Chiangrai Prachanukroh Hospital betweenJanuary 2000 to December 2009. There were twenty-five HIV-infected children, eight of them have receivedantiretroviral (ARV) therapy with 99.4% average adherence. ARV group had 37.5% side effects. Viral load wasundetectable after ARV therapy 9 months. Mean age of illness in ARV group was similar to non ARV group(20.1 months and 21.7 months, respectively). Sixty four percent of illness were found in HIV-infected children(16 of 25). Severe clinical conditions (category C) were diagnosed in non ARV group. All of them died at meanage 13.4 months by pneumonia probable P. jiroveci pneumonia (PCP), diagnosis by clinical criteria. High incidence rate of death were not received zidovudine (AZT) at birth, breast feeding and CD4 cellcount \< 350 cell/cu mm (p \< 0.05). The risk ratio of death in these groups were 54.75, 11.15 and 9.7, respectively.In conclusion, children who are not received zidovudine (AZT) at birth, breast feeding, low CD4 cell count \< 350cell/cu mm, severe clinical conditions (category C) and non ARV therapy are associated with high mortality rateand high risk ratio of death among perinatally HIV-infected children.
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Buddhachinaraj Medical Journal; Vol.27 (Supplement 1) May-Augst 2010; 293