1220. Pediatric HIV CDC Category A and B Dermatologic Diagnoses over 22 Years of Longitudinal Follow-up
Session: Poster Abstract Session: Pediatric HIV
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 1220_AmySturt_sm.pdf (1.4 MB)
  • Background: 

    Mucocutaneous conditions are common among HIV-infected children at presentation and throughout disease progression, and are part of the Center for Disease Control’s (CDC) clinical staging classification (MMWR 1994). However, their frequencies have not been fully evaluated in population-based, longitudinal studies in the era of highly active antiretroviral therapy (HAART).

    Methods: 

    We conducted a population-based, prospective, multi-center pediatric HIV surveillance project in 12 counties in Northern California. From 1988- 2009, 276 children with perinatally acquired HIV were followed longitudinally. We present the 276 children followed from birth and evaluate all category A, B, and C dermatologic conditions (MMWR 1994). Logistic regression models were used to estimate the effect of birth cohort and treatment on dermatologic diagnoses using R (Vienna, Austria).

    Results: 

    Of 276 children, the following had dermatologic diagnoses: 172, category A; 60, category B, 1, category C. Of all dermatologic diagnoses, 49% (85/172) occurred in the first year of life, with 64% (110/172) occurring in the first 2 years of life.  The most frequent category A dermatologic diagnosis was dermatitis (92.4%, 159/172). The most frequent category B dermatologic diagnosis was oropharyngeal thrush (80%, 48/60). Over 22 years of follow-up there was only one category C dermatologic diagnosis (Kaposi’s sarcoma). There was a significant decline in first category A dermatologic diagnoses by birth cohort: 78/101 (77%), cohort 1; 59/94 (63%), cohort 2; 35/81 (43%), cohort 3 (p< 0.001). There was also a significant decline in first category B dermatologic diagnoses by birth cohort: 28/101 (28%), cohort 1; 27/94 (29%), cohort 2; 5/81 (6%), cohort 3 (p<0.01).

    Conclusion:

    Over 22 years of follow-up, there was a significant decline in dermatologic diagnoses by clinical cohort, consistent with the introduction of antiretrovirals and eventually HAART.


    Subject Category: P. Pediatric and perinatal infections

    Amy Sturt, MD, Infectious Diseases and Geographical Medicine, Stanford University School of Medicine, Stanford, CA, Andrew Anglemyer, PhD, Pediatrics, Division of Infectious Diseases, Stanford University, Stanford, CA, David Berk, MD, Departments of Medicine and Pediatrics, Divisions of Dermatology, Washington University School of Medicine, St. Louise, MO and Yvonne Maldonado, MD, Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, CA

    Disclosures:

    A. Sturt, None

    A. Anglemyer, None

    D. Berk, None

    Y. Maldonado, None

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