Description of a specialized outpatient clinic as a reference center for children and adolescents living with HIV/AIDS in southern Brazil
Keywords:Pediatrics, STD/AIDS, Comprehensive health care
Introduction: Children living with HIV/AIDS require specialized care. Objective: To describe clinical and epidemiological characteristics of patients living with HIV/AIDS. Methods: Observational, descriptive study using medical records data of patients with HIV/AIDS under 14 years of age. Approved by the institution's Ethics Committee under number 1,432,517. Results: 60 cases were included; the median follow-up duration was 6.8 years; 50.0% were male; 88.3% were white; 75.0% were from the capital and metropolitan region. Prenatal records were available for 51 cases, but only 44.6% received antiretroviral therapy (ART) during pregnancy (mean duration of 3.3 months). HIV diagnosis was based on clinical symptoms in 28.3% of the cases, occurring in similar proportions for both childhood common infections and opportunistic infections. According to the CDC clinical classification (1994), at the start of follow-up, 56.6% of patients had moderate or severe symptoms, which would be reduced to only 18.3% upon reclassification at the last visit (p=0.016). Initially, 41.7% showed evidence of immunosuppression, compared to 19.9% at the time of the study (p=0.5). Only 6.6% remained asymptomatic. A decrease in the average number of hospitalizations was observed during follow-up. Conclusion: Among the cases diagnosed based on clinical symptoms, half were attributed to common childhood infections and lacked immunosuppression.
Oleske J, Minnefor A, Cooper Jr R, Thomas K, dela Cruz A, Ahdieh H, et al. Immune deficiency syndrome in children. JAMA.1983;249(17):2345-9. PMID: 6834633
Pizzo PA, Wilfert CM. Pediatric AIDS: HIV infection challenge in infants, children and adolescents. Baltimore: Williams and Wilkins; 1998.
UNAIDS. Global AIDS update 2021. Confronting inequalities. Lessons for pandemic responses from 40 years of AIDS [Internet]. 2021 [cited on 2023 Oct 30]. Available from: https://www.unaids.org/sites/default/files/media_asset/2021-global-aids-update_en.pdf
Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Secretaria de Vigilância em Saúde. Protocolo clínico e diretrizes terapêuticas para prevenção da transmissão vertical do HIV, sífilis e hepatites virais. Brasília: Ministério da Saúde; 2022.
Centers for Disease Control and Prevention (CDC). Revised surveillance case definition for HIV infection--United States, 2014. MMWR Recomm Rep. 2014;63(RR-03):1:10. PMID: 24717910
Dankner WM, Lindsey JC, Levin MJ; Pediatric AIDS Clinical Trials Group Protocol Teams 051, 128, 138, 144, 152, 179, 190, 220, 240, 245, 254, 300 and 327. Correlates of opportunistic infections in children infected with human immunodeficiency virus prior to administration of highly active antiretroviral therapy. Pediatr Infect Dis J. 2001;20(1):40-8. https://doi.org/10.1097/00006454-200101000-00008
Sauvageot D, Schaefer M, Olson D, Pujades-Rodriguez M, O'Brien DP. Antiretroviral therapy outcomes in resource-limited settings for HIV-infected children <5 years of age. Pediatrics. 2010;125(5):e1039-47. https://doi.org/10.1542/peds.2009-1062
Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O'Sullivan MJ, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994;331(18):1173-80. https://doi.org/10.1056/NEJM199411033311801
Mandelbrot G, Tubiana R, Le Chenadec J, Dollfus C, Faye A, Pannier E, et al. No perinatal HIV-1 transmission from women with effective antiretroviral therapy starting before conception. Clin Infect Dis. 2015;61(11):1715-25. https://doi.org/10.1093/cid/civ578
McSherry GD. Human immunodeficiency-virus-related pulmonary infections in children. Semin Respir Infect. 1996;11(3):173-83. PMID: 8883175
Cruz MLS, Cardoso CAA, Darmont MP, Souza E, Andrade SD, D'Al Fabbro MM, et al. Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study. J Pediatr (Rio J). 2014;90(6):563-71. https://doi.org/10.1016/j.jped.2014.04.007
Bertolli J, Hsu HW, Sukalac T, Williamson J, Peters V, Frederick T, et al. Hospitalization trends among children and youths with perinatal human immunodeficiency vírus infection, 1990–2002. Pediatr Infect Dis J. 2006;25(7):628-33. https://doi.org/10.1097/01.inf.0000220255.14636.b3
Gona P, Van Dyke RB, Williams PL, Dankner WM, Chernoff MC, Nachman SA, et al. Incidence of opportunistic and other infections in HIV-infected children in the HAART era. JAMA. 2006;296(3):292-300. https://doi.org/10.1001/jama.296.3.292
How to Cite
Copyright (c) 2023 Brazilian Journal of Sexually Transmitted Diseases
This work is licensed under a Creative Commons Attribution 4.0 International License.