Respiratory diseases in the first year of life in children born to HIV-1-infected women

Meyer Kattan, Arnold Platzker, Robert B. Mellins, Mark D. Schluchter, Xin C. Chen, Hannah Peavy, Suzanne Steinbach, Mary Ellen Wohl, Peter Hiatt, Janice Hunter, Andrew Colin

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

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-1-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.

Original languageEnglish
Pages (from-to)267-276
Number of pages10
JournalPediatric Pulmonology
Volume31
Issue number4
DOIs
StatePublished - Apr 18 2001
Externally publishedYes

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Keywords

  • Bronchiolitis
  • CD4 lymphocytes
  • HIV-1 infection
  • Infants
  • Pneumocystis carinii pneumonia
  • Pneumonia
  • Radiology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Kattan, M., Platzker, A., Mellins, R. B., Schluchter, M. D., Chen, X. C., Peavy, H., Steinbach, S., Wohl, M. E., Hiatt, P., Hunter, J., & Colin, A. (2001). Respiratory diseases in the first year of life in children born to HIV-1-infected women. Pediatric Pulmonology, 31(4), 267-276. https://doi.org/10.1002/ppul.1038