Incidence of noninfectious conditions in perinatally HIV-infected children and adolescents in the HAART era
Sharon A Nachman, Miriam Chernoff, Philimon Gona, Russell B Van Dyke, Wayne M Dankner, George R Seage 3rd, James Oleske, Paige L Williams, PACTG 219C Team, Arlene Bardeguez, Arry Dieudonne, Linda Bettica, Juliette Johnson, Stephen I Pelton, Ellen R Cooper, Lauren Kay, Ann Marie Regan, Joseph A Church, Theresa Dunaway, Audra Deveikis, Jagmohan Batra, Susan Marks, Ilaisanee Fineanganofo, Margaret A Keller, Nasser Redjal, Spring Wettgen, Sheryl Sullivan, Nancy Hutton, Beth Griffith, Mary Joyner, Carolyn Keifer, Douglas Watson, John Farley, Mary E Paul, Chivon D Jackson, Faith Minglana, Heidi Schwarzwald, Kenneth M Boyer, Jamie Martinez, James B McAuley, Maureen Haak, Michael Brady, Katalin Koranyi, Jane Hunkler, Charon Callaway, Gwendolyn B Scott, Charles D Mitchell, Claudia Florez, Joan Gamber, Diane W Wara, Ann Petru, Nicole Tilton, Mica Muscat, Ann Petru, Teresa Courville, Karen Gold, Katherine Eng, Stephen A Spector, Rolando M Viani, Mary Caffery, Kimberly Norris, Margaret Donnelly, Kathleen McGann, Carole Mathison, John Swetnam, Tom Belhorn, Jean Eddleman, Betsy Pitkin, Vincent R Bonagura, Susan Schuval, Blanka Kaplan, Constance Colter, Elaine J Abrams, Maxine Frere, Delia Calo, William Borkowsky, Nagamah Deygoo, Maryam Minter, Seham Akleh, Diana Dobbins, Deidre Wimbley, Lawrence D'Angelo, Hans Spiegel, Ann J Melvin, Kathleen M Mohan, Michele Acker, Suzanne Phelps, Kenneth C Rich, Karen Hayani, Julia Camacho, Warren A Andiman, Leslie Hurst, Janette de Jesus, Donna Schroeder, Denise Ferraro, Jane Perillo, Michele Kelly, Sohail Rana, Helga Finke, Patricia Yu, Jhoanna Roa, Andrea Kovacs, James Homans, Michael Neely, LaShonda Spencer, Mobeen H Rathore, Ayesha Mirza, Kathy Thoma, Almer Mendoza, Ana M Puga, Guillermo Talero, James Blood, Stefanie Juliano, Geoffrey A Weinberg, Barbra Murante, Susan Laverty, Francis Gigliotti, Suzanne R Lavoie, Tima Y Smith, Aditya Gaur, Katherine Knapp, Nehali Patel, Marion Donohoe, Irma L Febo, Licette Lugo, Ruth Santos, Ibet Heyer, Steven D Douglas, Richard M Rutstein, Carol A Vincent, Patricia C Coburn, Jill Foster, Janet Chen, Daniel Conway, Roberta Laguerre, Emma Stuard, Caroline Nubel, Stefan Hagmann, Murli Purswani, Mahrukh Bamji, Indu Pathak, Savita Manwani, Ekta Patel, Katherine Luzuriaga, Richard Moriarty, Barbara W Stechenberg, Donna J Fisher, Alicia M Johnston, Maripat Toye, Juan C Salazar, Kirsten Fullerton, Gail Karas, Stuart Foshee, Chitra S Mani, Dennis L Murray, Christopher White, Mary Y Mancao, Benjamin Estrada, Ronald D Wilcox, Margarita Silio, Thomas Alchediak, Cheryl Borne, Shelia Bradford, Sharon A Nachman, Miriam Chernoff, Philimon Gona, Russell B Van Dyke, Wayne M Dankner, George R Seage 3rd, James Oleske, Paige L Williams, PACTG 219C Team, Arlene Bardeguez, Arry Dieudonne, Linda Bettica, Juliette Johnson, Stephen I Pelton, Ellen R Cooper, Lauren Kay, Ann Marie Regan, Joseph A Church, Theresa Dunaway, Audra Deveikis, Jagmohan Batra, Susan Marks, Ilaisanee Fineanganofo, Margaret A Keller, Nasser Redjal, Spring Wettgen, Sheryl Sullivan, Nancy Hutton, Beth Griffith, Mary Joyner, Carolyn Keifer, Douglas Watson, John Farley, Mary E Paul, Chivon D Jackson, Faith Minglana, Heidi Schwarzwald, Kenneth M Boyer, Jamie Martinez, James B McAuley, Maureen Haak, Michael Brady, Katalin Koranyi, Jane Hunkler, Charon Callaway, Gwendolyn B Scott, Charles D Mitchell, Claudia Florez, Joan Gamber, Diane W Wara, Ann Petru, Nicole Tilton, Mica Muscat, Ann Petru, Teresa Courville, Karen Gold, Katherine Eng, Stephen A Spector, Rolando M Viani, Mary Caffery, Kimberly Norris, Margaret Donnelly, Kathleen McGann, Carole Mathison, John Swetnam, Tom Belhorn, Jean Eddleman, Betsy Pitkin, Vincent R Bonagura, Susan Schuval, Blanka Kaplan, Constance Colter, Elaine J Abrams, Maxine Frere, Delia Calo, William Borkowsky, Nagamah Deygoo, Maryam Minter, Seham Akleh, Diana Dobbins, Deidre Wimbley, Lawrence D'Angelo, Hans Spiegel, Ann J Melvin, Kathleen M Mohan, Michele Acker, Suzanne Phelps, Kenneth C Rich, Karen Hayani, Julia Camacho, Warren A Andiman, Leslie Hurst, Janette de Jesus, Donna Schroeder, Denise Ferraro, Jane Perillo, Michele Kelly, Sohail Rana, Helga Finke, Patricia Yu, Jhoanna Roa, Andrea Kovacs, James Homans, Michael Neely, LaShonda Spencer, Mobeen H Rathore, Ayesha Mirza, Kathy Thoma, Almer Mendoza, Ana M Puga, Guillermo Talero, James Blood, Stefanie Juliano, Geoffrey A Weinberg, Barbra Murante, Susan Laverty, Francis Gigliotti, Suzanne R Lavoie, Tima Y Smith, Aditya Gaur, Katherine Knapp, Nehali Patel, Marion Donohoe, Irma L Febo, Licette Lugo, Ruth Santos, Ibet Heyer, Steven D Douglas, Richard M Rutstein, Carol A Vincent, Patricia C Coburn, Jill Foster, Janet Chen, Daniel Conway, Roberta Laguerre, Emma Stuard, Caroline Nubel, Stefan Hagmann, Murli Purswani, Mahrukh Bamji, Indu Pathak, Savita Manwani, Ekta Patel, Katherine Luzuriaga, Richard Moriarty, Barbara W Stechenberg, Donna J Fisher, Alicia M Johnston, Maripat Toye, Juan C Salazar, Kirsten Fullerton, Gail Karas, Stuart Foshee, Chitra S Mani, Dennis L Murray, Christopher White, Mary Y Mancao, Benjamin Estrada, Ronald D Wilcox, Margarita Silio, Thomas Alchediak, Cheryl Borne, Shelia Bradford
Abstract
Objective: To estimate highly active antiretroviral therapy (HAART)-era incident rates for the first episode of noninfectious conditions in human immunodeficiency virus (HIV)-infected youth in order to identify HAART-era changes in the natural history of perinatal HIV infection.
Design: Multicenter prospective cohort study.
Setting: More than 80 sites in the United States including Puerto Rico.
Patients: Perinatally HIV-infected youth.
Main outcome measures: Incidence rates (IRs) per 100 person-years were calculated for targeted noninfectious conditions occurring in perinatally HIV-infected children. A chi(2) test for linear trend was used to evaluate changes in the rates from 2001 to 2006.
Results: Two thousand five hundred seventy-five perinatally HIV-infected children (51%, female; 59%, black, non-Hispanic) were enrolled in Pediatric AIDS Clinical Trials Group (PACTG) 219C between 2000 and 2006 and were followed up for a median of 59 months. The 10 most common noninfectious conditions were pregnancy conditions (IR = 6.16; 95% confidence interval (CI), 3.9-9.3), birth defects (IR = 0.19; 95% CI, 0.1-0.3), gynecological dysplasias (IR = 5.92; 95% CI, 3.9-8.6), condyloma (IR = 0.15; 95% CI, 0.1-0.2), encephalopathy (IR = 0.38; 95% CI, 0.3-0.5), pancreatitis (IR = 0.30; 95% CI, 0.2-0.4), cardiac disorders (IR = 0.28; 95% CI, 0.2-0.4), renal disorders (IR = 0.26; 95% CI, 0.2-0.4), peripheral neuropathy (IR = 0.23; 95% CI, 0.2-0.4), and idiopathic thrombocytic purpura (IR = 0.15; 95% CI, 0.1-0.3). Among these conditions, 5 showed significant trends, with IRs increasing over time in pregnancy-related conditions (P < .001) and gynecological dysplasias (P = .02) while IRs decreased over time for encephalopathy (P < .001), pancreatitis (P = .002), and cardiac disorders (P = .007).
Conclusions: Between 2001 and 2006, the incidence for 3 conditions decreased and increased for 2 others, demonstrating the change in medical issues and conditions in perinatally infected youth. Continued surveillance with appropriate tools will be needed to assess the long-term effects of HAART and HIV as well as development of new noninfectious conditions of HIV.
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Source: PubMed