Understanding the contribution of common childhood illnesses and opportunistic infections to morbidity and mortality in children living with HIV in resource-limited settings

Details

• Alternative Title:
  AIDS
• Personal Author:
  Modi, Surbhi ; Chiu, Alex ; Ng’eno, Bernadette ; Kellerman, Scott E. ; Sugandhi, Nandita ; Muhe, Lulu
• Corporate Authors:
  The Child Survival Working Group of the Interagency Task Team on the Prevention and Treatment of HIV Infection in Pregnant Women, Mothers and Child*
• Description:
  Objective ; Although antiretroviral treatment (ART) has reduced the incidence of HIV-related opportunistic infections among children living with HIV, access to ART remains limited for children, especially in resource-limited settings. This paper reviews current knowledge on the contribution of opportunistic infections and common childhood illnesses to morbidity and mortality in children living with HIV, highlights interventions known to improve the health of children, and identifies research gaps for further exploration. ; Design and Methods ; Literature review of peer-reviewed articles and abstracts combined with expert opinion and operational experience. ; Results ; Morbidity and mortality due to opportunistic infections has decreased in both developed and resource-limited countries. However, the burden of HIV-related infections remains high, especially in sub-Saharan Africa, where the majority of HIV-infected children live. Limitations in diagnostic capacity in resource-limited settings have resulted in a relative paucity of data on opportunistic infections in children. Additionally, the reliance on clinical diagnosis means that opportunistic infections are often confused with common childhood illnesses which also contribute to excess morbidity and mortality in these children. Although several preventive interventions have been shown to decrease opportunistic infection-related mortality, implementation of many of these interventions remains inconsistent. ; Conclusions ; In order to reduce opportunistic infection-related mortality, early ART must be expanded, training for front-line clinicians must be improved, and additional research is needed to improve screening and diagnostic algorithms.
• Keywords:
  • children
  • HIV
  • mortality
  • opportunistic infections
  • AIDS-Related Opportunistic Infections
  • Anti-HIV Agents
  • Anti-Retroviral Agents
  • Child
  • Child, Preschool
  • Communicable Disease Control
  More +
• Source:
  AIDS. 27(0 2):S159-S167
• Pubmed ID:
  24361625
• Pubmed Central ID:
  PMC4648290
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  27
• Download URL:
  https://stacks.cdc.gov/view/cdc/36662/cdc_36662_DS1.pdf
• File Type:
  [PDF - 100.30 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:36307a6e212409a2da6a6051fcedf2c12078c83f428b41c8c2b82df5f7c4d3aa