Morbidity and mortality in European children vertically infected by HIV-1 - The French pediatric HIV infection study group and European collaborative study
Morbidity and mortality in European children vertically infected by HIV-1 - The French pediatric HIV infection study group and European collaborative study
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DOI：
10.1097/00042560-199704150-00008
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发表时间：
1997-04-15
期刊：
影响因子：
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通讯作者：
Peckham, CS
中科院分区：
文献类型：
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作者：
Blanche, S;Newell, ML;Peckham, CS
根据392名感染儿童参加了两项欧洲前瞻性研究的婴儿出生的艾滋病毒感染的妇女，类似的标准协议，艾滋病毒疾病的进展，在第一个6年的生活，使用1994年疾病预防控制中心儿科艾滋病毒分类。大多数儿童在出生后的前4年内患有轻微（A）或中重度（B）疾病，尽管通常是暂时性的。在生命的第一年，进展到美国疾病控制和预防中心（CDC）C组疾病或HIV相关死亡的估计为20%（95%置信区间16-24%），此后每年为4.7%（3.3-65%），6年累积发生率为36%（30-43%）。6年死亡率为26%（20-32%）。在6岁时存活的儿童中，三分之二只有轻微症状，三分之一的儿童尽管有先前的临床表现和短暂的中度免疫缺陷，但CD 4（+）细胞分布>25%。两个队列中齐多夫定单药治疗的差异与死亡率无关。然而，在法国队列中，严重细菌感染的风险较低，其中使用抗菌药物预防更为常见。早期、严重的艾滋病毒疾病影响到20%的婴儿，6年后75%的受感染儿童仍然活着。这对保健规划具有重要意义。
Based on 392 infected children enrolled in two European prospective studies of infants born to HIV-infected women, with similar standard protocols, HIV disease progression in the first 6 years of life is described, using the 1994 CDC paediatric HIV classification. Most children had developed minor (A) or moderately severe (B) illness in the first 4 years of life, although usually it was transient in nature. Progression to U.S. Centers for Disease Control and Prevention (CDC) group C disease or HIV-related death is an estimated 20% (95% confidence interval 16-24%) during the first year of life, and 4.7% (3.3-65%) per year thereafter, giving a cumulative incidence of 36% (30-43%) by 6 years. The mortality rate at 6 years is 26% (20-32%). Two thirds of the children alive at 6 years had only minor symptoms, and one third had a CD4(+) cell distribution of >25% despite previous clinical manifestations and a transient period of moderate immune deficiency. Differences in zidovudine monotherapy between the two cohorts were not associated with the mortality rate. However, the risk of severe bacterial infections was lower in the French cohort, in which the use of antibacterial prophylaxis was more common. The early, severe form of HIV disease affects similar to 20% of infants, and after 6 years 75% of infected children are still alive. This has important implications for health-care planning.