Pediatric Guidelines for Infection Control of Human Immunodeficiency Virus (Acquired Immunodeficiency Virus) in Hospitals, Medical Offices, Schools, and Other Settings

PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 801-807
Author(s):  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Infection Control ◽  
Hiv Infection ◽  
The United States ◽  
Pediatric Hiv ◽  
Intravenous Drug ◽  
Clotting Factor ◽  
Maternal Infection ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency

Acquired immunodeficiency syndrome (AIDS), the most severe manifestation of infection with the human immunodeficiency virus (HIV), has been diagnosed in more than 900 children younger than 13 years of age throughout the United States as of May 1988, 77% of whom were infected in utero or perinatally secondary to maternal infection. Risk factors for maternal infection include intravenous drug abuse or sexual contact with partners who are intravenous drug abusers or bisexual. The remainder of children, including a high proportion of hemophiliacs, have been infected by blood or clotting factor infusion between 1979 and 1985. In addition, adolescents have acquired infection through sexual activity and intravenous drug use, as well as transfusion of contaminated blood or blood factors. The criteria for diagnosis of AIDS in children differ in some ways from those for adults, and the most recently published diagnostic criteria (Morbidity Mortality Weekly Report, Aug 14, 1987) include the expanded spectrum of disease, such as recurrent bacterial infections and encephalopathy, as well as including children with presumptive diagnosis of AIDS-associated diseases such as lymphpoid interstitial pneumonitis. There is no accurate estimate of the numbers of infected asymptomatic children or of infected children with milder symptoms that do not meet the criteria for the diagnosis of AIDS. Although most cases of pediatric HIV infection have been identified in New York City, Newark, Miami, and Los Angeles, cases are appearing in other locations. Thus, HIV infection in childhood is becoming more widespread, but in many states it is still rare. Because the cause of AIDS is a virus transmissible from human to human, pediatric health care workers must adjust infection control guidelines to meet this new threat.

Decreased Thymus Size on Chest Radiography: A Sign of Pediatric Human Immunodeficiency Virus Infection?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 99-102
Author(s):  
ALAN MEYERS ◽  
NICHOLAS PEPE ◽  
WILLIAM CRANLEY ◽  
KATHLEEN MCCARTEN
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Chest Radiography ◽  
Pediatric Hiv ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Generalized Lymphadenopathy ◽  
Immunodeficiency Syndrome ◽  
Thymus Size

The early diagnosis of infection with the human immunodeficiency virus (HIV) in infancy is clinically important but remains problematic in the asymptomatic child born to an HIV-infected mother. In addition, many such women are unaware of their HIV infection until their child manifests symptomatic HIV disease. Nonspecific signs of pediatric HIV infection, such as generalized lymphadenopathy, hepatosplenomegaly, or persistent thrush, may be important in alerting the clinician to consider the possibility of HIV infection in the child whose history of HIV risk is unknown. We report one such sign which may be evident on plain chest radiography. The pathology of the thymus gland in pediatric acquired immunodeficiency syndrome has been described by Joshi and colleagues,1-3 who have reported precocious involution with marked reduction in thymus size and weight.

Human Immunodeficiency Virus and Artificial Feeding

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 804-804
Author(s):  
STANLEY A. PLOTKIN
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Developing Countries ◽  
Breast Milk ◽  
Infection Control ◽  
Hiv Infection ◽  
Developed Countries ◽  
The United States ◽  
Artificial Feeding ◽  
Immunodeficiency Virus

Dr Halsey has brought to my attention that a sentence in the human immunodeficiency virus (HIV) infection control statement (AAP News, September 1988) and perinatal statement (Pediatrics 1988;82:941-944) might be misinterpreted as advocating artificial feeding for HP/-infected infants in developing countries. It was our intention to advocate the use of artificial feeding by HIV-infected mothers only in the United States and other developed countries where safe water and hygienic practices are the norm. In other countries, the advantages of breast milk outweigh the possible risk of transmission to the newborn.

Educating podiatric medical assistants about AIDS and HIV infection

1990 ◽  
Vol 80 (1) ◽  
pp. 36-40 ◽  
Author(s):  
CA Holmes
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Infection Control ◽  
Hiv Infection ◽  
Medical Assistants ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Infection Control Guidelines

In order to assess the need for acquired immunodeficiency syndrome education among podiatric assistants, comprehensive questionnaires on human immunodeficiency virus infection were distributed in February and March 1989. The findings presented here are based upon questionnaires completed and returned by 300 assistants. The purpose of the needs assessment was three-fold: to find out how much the surveyed assistants know about AIDS and HIV infection, how they feel about working with HIV-infected patients, and to what extent they understand and follow recommended infection control practices. The results of the survey reveal that many of the assistants in the sample in this study are ill-informed about HIV infection, that they have numerous concerns and fears about working with HIV-infected patients, and that they are not following recommended infection control guidelines.

scholarly journals Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection: National Case Surveillance Data During 20 Years of the HIV Epidemic in the United States

2003 ◽  
Vol 24 (2) ◽  
pp. 86-96 ◽  
Author(s):  
Ann N. Do ◽  
Carol A. Ciesielski ◽  
Russ P. Metler ◽  
Teresa A. Hammett ◽  
Jianmin Li ◽  
...  
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Healthcare Workers ◽  
The United States ◽  
Surveillance Systems ◽  
National Surveillance ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

AbstractObjective:To characterize occupationally acquired human immunodeficiency virus (HIV) infection detected through case surveillance efforts in the United States.Design:National surveillance systems, based on voluntary case reporting.Setting:Healthcare or laboratory (clinical or research) settings.Patients:Healthcare workers, defined as individuals employed in healthcare or laboratory settings (including students and trainees), who are infected with HIV.Methods:Review of data reported through December 2001 in the HIV/AIDS Reporting System and the National Surveillance for Occupationally Acquired HIV Infection.Results:Of 57 healthcare workers with documented occupationally acquired HIV infection, most (86%) were exposed to blood, and most (88%) had percutaneous injuries. The circumstances varied among 51 percutaneous injuries, with the largest proportion (41%) occurring after a procedure, 35% occurring during a procedure, and 20% occurring during disposal of sharp objects. Unexpected circumstances difficult to anticipate during or after procedures accounted for 20% of all injuries. Of 55 known source patients, most (69%) had acquired immunodeficiency syndrome (AIDS) at the time of occupational exposure, but some (11%) had asymptomatic HIV infection. Eight (14%) of the healthcare workers were infected despite receiving postexposure prophylaxis (PEP).Conclusions:Prevention strategies for occupationally acquired HIV infection should continue to emphasize avoiding blood exposures. Healthcare workers should be educated about both the benefits and the limitations of PEP, which does not always prevent HIV infection following an exposure. Technologic advances (eg, safety-engineered devices) may further enhance safety in the healthcare workplace

ACQUIRED IMMUNODEFICIENCY SYNDROME, HUMAN IMMUNODEFICIENCY VIRUS AND HEMOPHILIA

1987 ◽  
Author(s):  
P H Levine
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Specific Activity ◽  
Subsequent Development ◽  
Immune Dysfunction ◽  
The United States ◽  
Clotting Factor ◽  
Increased Risk ◽  
Immunodeficiency Virus

Less than 15 years ago the National Heart, Lung and Blood Institute surveyed physicians in the United States in order to characterize the demographics of hemophilia. The average age of persons with hemophilia in the United States was found to be 11.5 years old. By 10 years later, the life expectancy was predicted to be normal, and indeed the average age of persons with hemophilia in the U.S. is now in the early twenties. Early, intensive and predictably efficacious control of hemorrhage has made this result possible, and the therapeutic product which has allowed such control is commercial clotting factor concentrate.We now know that starting in 1978, and with great frquency during 1982 and 1983, the majority of U.S. hemophiliacs were infected with human immunodeficiency virus (HIV). It is estimated that as of January, 1987, approximately two thirds of the 20,000' persons with hemophilia in the United States have been infected with HIV. Among those with severe factor VIII deficiency, more than 9056 are seropositive. As of 1/5/87, there were 288 cases of AIDS among U.S. hemophiliacs, for an AIDS rate of approximately 2.256 of those with HIV infection. This number included 185 with severe, 32 with moderate and 28 with mild hemophilia A; 12 with severe, 6 with moderate and 1 with mild hemophilia B; 9 with vWD, and 4 others. A disproportionate number were older patients: 55 were ages 1-19; 62 ages 20-29; 85 ages 30-39, and 86 age 40 or older. Although the AIDS attack rate is no longer climbing logarhythmically, new cases are certainly still occurring.A variety of other HIV-related syndromes have emerged. Of great concern is immune thrombocytopenia, which is now relatively common; among a group of 209 carefully followed HIV-positive patients at our center, 31 (1556) are or have been thrombocytopenic. Progressive failure to normally gain height and weight in children with hemophilia has recently been shown by our group to correlate with HIV antibody positivity, and also with decreased T4/T8 ratio, decreased T4 cell count, decreased skin test reactivity, and subsequent development of ARC or AIDS in some such children. Finally, a picture of progressive fall in T4 count associated with recurrent non-specific infections and increased likelihood of positive viral culture, may predict an increased risk of developing AIDS.We know that the immune dysfunction in hemophilia is complex, and not wholly explained by HIV infection. One important factor may be the many foreign proteins contained in commercial clotting factor concentrates, and their ability to stimulate T cells. It is known that latent HIV infection in cultured T4 lymphocytes can be induced to enter the proliferative, viral secretory phase by the addition of soluble foreign antigens to the cell culture. Recent data of Brettler and colleagues, to be presented at this meeting, suggest that the use of highly purified VI!I:C (specific activity >3000 u/mg) in place of the present extremely impure products, may improve the immune dysfunction in hemophilia. This observation offers a new hypothetical approach to the prevention of progressive T4 cell depletion in HIV infected hemophiliacs, and requires immediate and extensive further study.The psychosocial burden of HIV infection is immense. The need for extensive, formal education and support programs is largely unmet in most parts of the world. Such programs are best run out of hemophilia treatment centers in most cases, and must include an active program on prevention of sexual transmission, provision of HIV testing before and during pregnancies, provision for maintenance of confidentiality, etc. Education concerning HIV is like all other forms of education. It requires formal organization, a curriculum, active rather than passive learning in which there is interaction between the teacher and the pupil, time for planned repetition, reinforcement with written materials, and assessment of goals achieved. For all of these reasons it is inappropriate to assume that the physician at the hemophilia center will be able to provide an adequate education program. Adquate paramedical personnel will need to undertake this effort, under the directjon of the physician.

Role of the General Pediatrician in the Management of Human Immunodeficiency Virus Infection in Children

1993 ◽  
Vol 14 (10) ◽  
pp. 371-379
Author(s):  
Thomas H. Rand ◽  
Alan Meyers
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
The United States ◽  
Care Physician ◽  
Pediatric Hiv ◽  
Delivery Of Care ◽  
Advanced Immunodeficiency ◽  
Immunodeficiency Virus ◽  
Chronic Progressive Disease

Human immunodeficiency virus (HIV) infection is a chronic progressive disease affecting an estimated 20 000 children in the United States. Management of this infection and its complications is evolving rapidly and requires the coordinated services of a number of disciplines, which may be facilitated by centers having programs in pediatric HIV infection. However, much of the care for an HIV-infected child can be supervised by a primary care physician, particularly during the early phase of infection, when anticipatory health monitoring is emphasized. Many pediatricians have had no experience with HIV infection during residency training, and those who have may have cared only for inpatients who had advanced immunodeficiency. The trend in medical care for HIV infection is toward early detection and management, as in other chronic diseases of childhood. This review summarizes those aspects of HIV infection most likely to be encountered in general pediatric practice. There are several distinct problems in the delivery of care for infants and children who are infected with HIV: 1) At this time, HIV infection is a progressive, ultimately fatal disease. Interventions are directed at preserving function and quality of life. 2) HIV is an infectious disease. Preventing transmission should be addressed at every opportunity, both to point out activities having potential for transmission and to reassure families of the safety of other types of contact.

scholarly journals Pediatric HIV Infection

2013 ◽  
Vol 4 (1) ◽  
pp. 77-79
Author(s):  
Ambrish Kaushal ◽  
Yogesh Upadhyay
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Acquired Immunodeficiency Syndrome ◽  
Infants And Children ◽  
Pediatric Hiv ◽  
General Review ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Considerable Morbidity ◽  
Immunodeficiency Syndrome

ABSTRACT Acquired immunodeficiency syndrome (AIDS) is caused by human immunodeficiency virus (HIV). The pathologic hallmark of AIDS is severe immunosuppression; HIV infected infants and children suffer considerable morbidity and mortality. In addition to the catastrophic medical consequences, HIV infected infants and children along with their families suffer tremendous psychological upheaval owing to this chronic, often devastating illness. Because of the complexity and vast clinical spectrum of HIV infection, this article is limited to a general review of the pediatric HIV manifestations and management. How to cite this article Kaushal A, Upadhyay Y. Pediatric HIV Infection. World J Dent 2013;4(1):77-79.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

Perinatal Human Immunodeficiency Virus (HIV) Testing

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 791-794
Author(s):  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Vertical Transmission ◽  
Task Force ◽  
Perinatal Transmission ◽  
Pediatric Hiv ◽  
Number Of Children ◽  
Perinatal Hiv ◽  
Seroprevalence Data ◽  
Immunodeficiency Virus

PERINATAL INFECTIONS The primary route of human immunodeficiency virus (HIV) infection in infants is vertical transmission from HIV-infected mothers. This is of particular concern as the number of infected women and the number of children infected by perinatal transmission continue to increase rapidly. The number of perinatally acquired acquired immunodeficiency syndrome (AIDS) cases increased 17% in 1989 and 21% in 1990. Similarly, the number of heterosexually acquired AIDS cases increased 27% in 1989 and 40% in 1990. There is evidence that vertical transmission of HIV can occur in utero (congenital/transplacental, similar to rubella),1,2 in the postpartum period (breast-feeding), and perhaps in the intrapartum period (similar to hepatitis B).3 The relative frequency and efficiency of transmission during each of these periods remains uncertain. The best estimates of vertical transmission from an HIV-seropositive mother to the fetus range from 12.9% to 39%4-6 Although the risk of transmission appears to be increased in women who are symptomatic, this point is still unclear.5 Preliminary information suggests that the presence of high levels of high-affinity/avidity antibodies to specific epitopes of the gp 120 of HIV may be protective and may decrease or prevent vertical transmission,7-10 although others have not been able to confirm this finding.11 More detailed information on perinatal HIV infection,12 and infection control13 in pediatric HIV infection is available in previously published statements from the AAP Task Force on Pediatric AIDS. SEROPREVALENCE Anonymous seroprevalence data from newborn specimens are being collected in 44 states, Puerto Rico, and the District of Columbia. In some states, seroprevalence data are available by metropolitan area and/or by hospital of birth.

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