Respiratory diseases in the first year of life in children born to HIV-1-infected women
Respiratory diseases in the first year of life in children born to HIV-1-infected women
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DOI：
10.1002/ppul.1038
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发表时间：
2001-04-01
影响因子：
3.1
通讯作者：
Colin, AA
中科院分区：
文献类型：
--
作者：
Kattan, M;Platzker, A;Colin, AA
我们的目的是描述HIV-1感染妇女所生的感染和未感染儿童的呼吸系统并发症、临床表现和出生后第一年的胸部X线改变。我们在一项多中心研究中前瞻性地随访了600名HIV-1感染妇女所生婴儿从出生到12个月的队列。其中93名婴儿（15.5%）为HIV-1感染者，463人未感染，HIV-1感染儿童12个月时首次肺炎发作的累积发病率（+/- SE）为24.1 +/- 4.7%，而未感染HIV-1的儿童为1.4 +/-0.6（P < 0.001）。卡氏肺孢子虫肺炎（PCP）的发病率为每100名儿童年9.5人。在第一年发生肺炎的人群中，HIV-1 RNA载量并不比那些没有发生肺炎的人群高。患有下呼吸道感染或PCP的儿童在生命的前6个月内CD 4细胞计数下降的速度增加。母亲CD 4细胞计数较低与肺炎、上呼吸道和下呼吸道感染的发生率较高相关。感染儿童的上呼吸道感染和细支气管炎/反应性气道疾病的发生率与未感染儿童无显著差异。12个月时，HIV-1感染的儿童比未感染的儿童呼吸急促和胸部X线片显示结节和网状密度明显增加。在生命的第一年，巨细胞病毒感染和影像学改变或肺炎的发生率之间没有关系。总之，尽管PCP的发病率很低，但感染HIV的儿童在生命的第一年肺炎的发病率仍然很高。感染HIV-1的母亲所生的未感染婴儿的肺炎发病率很低。胸部X线异常和呼吸急促提示感染婴儿存在亚急性疾病。需要采取进一步的后续行动，以确定其性质。 2001年威利-利斯。Inc.
Our objective was to describe the respiratory complications, clinical findings, and chest radiographic changes in the first year of life in infected and uninfected children born to HIV-1-infected women. We prospectively followed a cohort of 600 infants born to HIV-l-infected women from birth to 12 months in a multicenter study. Of these, 93 infants (15.5%) were HIV-1 infected, 463 were uninfected, and 44 were of unknown status prior to death or loss to follow-up.The cumulative incidence (+/- SE) of an initial pneumonia episode at 12 months was 24.1 +/- 4.7% in HIV-1-infected children compared to 1.4 +/- 0.6% in HIV-1-uninfected children (P < 0.001). The rate of Pneumocystis carinii pneumonia (PCP) was 9.5 per 100 child-years. The HIV-1 RNA load was not higher in the group that developed pneumonia in the first year vs. those who did not. Children who developed lower respiratory tract infections or PCP had increased rates of decline of CD4 cell counts during the first 6 months of life. Lower maternal CD4 cell counts were associated with higher rates of pneumonia, and upper and lower respiratory tract infections, The rates of upper respiratory tract infection and bronchiolitis/reactive airway disease in infected children were not significantly different than in uninfected children. At 12 months, significantly more HIV-1-infected than uninfected children had tachypnea and chest radiographs with nodular and reticular densities. There was no relationship between cytomegalo virus infection in the first year of life and radiographic changes or occurrences of pneumonia.In conclusion, despite a low incidence of PCP, rates of pneumonia remain high in HIV-infected children in the first year of life. The incidence of pneumonia in uninfected infants born to HIV-1-infected mothers is low. Chest X-ray abnormalities and tachypnea suggest that subacute disease is present in infected infants. Further follow-up is warranted to determine its nature. 2001 Wiley-Liss. Inc.