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New subset of HIV-infected neonates identified with rapidly progressive disease
Last Updated: 2001-04-27 18:15:04 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - Researchers in South Africa have identified a new category of preterm, growth-retarded HIV-1-infected neonates in whom the clinical appearance of perinatal coinfection during the first 28 days of life signals rapidly progressive HIV-1 and early death.
Dr. Thillagavathie Pillay from the University of Natal in Durban, South Africa, and colleagues collected data on perinatal infection among 32 HIV-1-exposed neonates who developed hepatosplenomegaly, lymphadenopathy or persistent pneumonia during the first 28 days of life.
Of the 32 infants, 23 were HIV-1-infected, with a median viral load of 471,932 copies/mL and a median CD4+ count of 777 cells/mm³. Most of these infants were premature and presented with growth retardation, the researchers report in the April issue of the Pediatric Infectious Disease Journal..
Of the HIV-infected infants, 8 were coinfected with tuberculosis, 6 with syphilis, and 10 with cytomegalovirus. During followup, clinical signs persisted or worsened in all of these infants, and by 9 months, 19 infants had died (mean age at death 3.5 months), the investigators note.
Dr. Pillay's group was able to confirm in utero HIV-1 transmission in five of the infants, but they "suspect that the remaining neonates, by virtue of their early clinical signs and positive HIV-1 PCR by a mean of 15.2 days, were most likely infected with HIV-1 in utero."
Dr. Pillay and colleagues conclude, "This study furthers the growing evidence that coinfections in mothers and neonates may play a synergistic role in the pathogenesis of perinatal HIV-1."
Pediatr Infect Dis J 2001;20:404-410.
-Westport Newsroom 203 319 2700
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