Long Term Outcomes of a Cohort of HIV-Infected Children in Mexico City, 1998-2013
Worldwide, morbidity and mortality associated with HIV in children has decreased. In Mexico the information available is limited. We describe the sociodemographic features, clinical manifestations, laboratory parameters, antiretroviral history and the follow up of a cohort of HIV infected children during 1998-2013.
We reviewed medical records and database of a cohort of children with diagnosis or suspected HIV infection, which were in follow up at Pediatric HIV Clinic, National Autonomous University of Mexico/General Hospital of Mexico.
It was obtained sociodemographic, clinical and laboratory features at baseline and last visit data.
A total of 669 children and adolescents with diagnosis or suspected HIV infection attended the study period; 445 children was non-infected at follow up (217 children <2 years and 228 children > 2 years). In 224 children HIV/AIDS diagnosis was established, 54% were male. HIV transmission was perinatal in 95% of the cases. 52% were residents of Mexico City.
During admission to the Clinic, median age was four years (0-16.8 years). 139 (62%) patients were in advanced diseases. Median viral load was 689 439 cop/mL (300 - > 10,000,000). Median CD4+ count was 666 del/uL (3-3254).
At the time of this study, 62% were orphans. Median CD4+ count was 754/uL (12-2867) and we observed undetectable viral load (<40 copias) in 78.8% of the children. They had received antiretroviral treatment on average during 89 months.
During the study period there was a loss of follow-up of 42 (19%) children, 15 patients died and 11 were transferred to adult service. Twenty five patients were hospitalized, the most, with pneumonia (36%).
Diagnosis of pediatric HIV cases in Mexico continue to occur despite interventions to eliminate the number of cases. The diagnosis of HIV in the population studied was performed in most cases when they had advanced stages of the disease. Although morbidity and mortality has decreased mainly secondary to HAART, efforts in this age group should be directed to the elimination and early diagnosis of new cases.
L. P. Tovar-Larrea, None
J. I. Santos-Preciado, None
N. Pavia-Ruz, None