Article

Delayed recognition of human immunodeficiency virus infection in preadolescent children.

Department of Pediatrics, New York University Medical Center/Bellevue Hospital Center, New York, NY 10016.
Pediatrics (impact factor: 5.44). 12/1992; 90(5):688-91.
Source: PubMed

ABSTRACT Thirty-two (18%) of 181 children cared for at our institution who were infected with the human immunodeficiency virus type 1 (HIV-1) were first seen, and HIV was diagnosed, when they were 4 years of age and older. Initial complaints or diagnoses for these children included the following: hematologic disorders (5) (3 idiopathic thrombocytopenic purpura, 1 neutropenia, 1 anemia); recurrent bacterial infections (10); Pneumocystis carinii pneumonia (3); developmental delay (1); skin disorders (2) (1 genital wart, 1 chronic zoster); weight loss (3); malignancy (1); and nephropathy (1). Eight children were referred for evaluation because of maternal HIV-1 infection. The risk factors for HIV-1 infection included maternal/perinatal exposure (22), perinatal blood transfusion (6), blood transfusion during infancy (2), and sexual abuse (2). Ten (31%) of the 32 children have subsequently died. The longest survival from perinatal infection was 12 years. HIV-1 infection in children can result in a prolonged clinical latency and can masquerade as other pathologic conditions. The absence of clinical symptoms in older children at risk for HIV-1 infection should not deter HIV testing.

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Keywords

1 chronic zoster
 
1 genital wart
 
1 neutropenia
 
181 children cared
 
3 idiopathic thrombocytopenic purpura
 
32 children
 
blood transfusion
 
developmental delay
 
HIV testing
 
human immunodeficiency virus type 1
 
Initial complaints
 
maternal HIV-1 infection
 
older children
 
pathologic conditions
 
perinatal blood transfusion
 
Pneumocystis carinii pneumonia
 
prolonged clinical latency
 
recurrent bacterial infections
 
sexual abuse
 
weight loss