Community-acquired pneumonia in HIV-infected children: a global perspective

  title={Community-acquired pneumonia in HIV-infected children: a global perspective},
  author={DM Gray and H. J. Zar},
  journal={Current Opinion in Pulmonary Medicine},
  • D. GrayH. Zar
  • Published 1 May 2010
  • Medicine, Biology
  • Current Opinion in Pulmonary Medicine
Purpose of review Pneumonia is a leading cause of morbidity and death in HIV-infected children. The aim of this study was to review recent advances in the epidemiology, cause, management and prevention of pneumonia in HIV-infected children. Recent findings Pneumonia remains a major cause of death and hospitalization, particularly in sub-Saharan Africa, where the paediatric HIV epidemic is concentrated. HIV-infected children have a higher risk of developing pneumonia and of more severe disease… 

Tuberculosis and pneumonia in HIV-infected children: an overview

The impact of tuberculosis and other lower respiratory tract infections on the health of HIV-infected infants and children is discussed.

Severe Recurrent Bacterial Pneumonia Among Children Living With HIV

Children <10-years-old and those with low weight-for-age, a history of respiratory illness, low CD4% or poorly controlled HIV are likely to gain the greatest benefit from targeted prevention and treatment programs to reduce the burden of bacterial pneumonia in children living with HIV.

The impact of highly active antiretroviral therapy on the burden of bacterial lower respiratory tract infections in children.

HAART is effective in reducing the burden of LRTIs in HIV-positive children, even when the diagnosis is delayed, and cough and fast breathing are still the most reliable presenting symptoms of pneumonia.

Community-acquired pneumonia in children — a changing spectrum of disease

Better access to effective preventative and management strategies is needed in low- and middle-income countries, while new strategies are needed to address the residual burden of disease once these have been implemented.

Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

The pediatric immune response to M. tuberculosis is described and the existing evidence of the impact of co-infection with other pathogens, as well as vaccination, on the host response is reviewed, particularly evaluating if co- Infections drive host immune responses in an age-dependent way.

High Viremia and Wasting Before Antiretroviral Therapy Are Associated With Pneumonia in Early-Treated HIV-Infected Kenyan Infants

In early ART-treated HIV-infected infants, higher HIV RNA and wasting before ART were independent risk factors for pneumonia, and wood fuel use was associated with URI and pneumonia.

Mathematical Modelling and Optimal Controls for Controlling Pneumonia-HIV Co-Infection

This research is aimed at determining optimal control treatments through developing a deterministic mathematical model Pneumonia-HIV coinfection incorporating the use of anti-pneumonia and ART treatment interventions as controls.

Associations between Potential Bacterial Pathogens in the Nasopharynx of HIV Infected Children

Findings provide insight into the increased risk of invasive disease from these organisms in HIV infected children and a strong positive association between carriage with H. influenzae and S. pneumoniae are found.

Diagnosis and management of community-acquired pneumonia in children: South African Thoracic Society guidelines

Background Pneumonia remains a major cause of morbidity and mortality amongst South African children. More comprehensive immunisation regimens, strengthening of HIV programmes, improvement in



Aetiology and outcome of pneumonia in human immunodeficiency virus‐infected children hospitalized in South Africa

To determine the aetiology and outcome of pneumonia in human immunodeficiency virus (HIV)‐infected children, 250 children hospitalized with pneumonia who were known or clinically suspected to be HIV‐positive, or who required intensive care support in Cape Town, South Africa were investigated.

The etiology and outcome of pneumonia in human immunodeficiency virus-infected children admitted to intensive care in a developing country

  • H. ZarP. Apolles G. Hussey
  • Medicine, Biology
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2001
HIV-infected children admitted with pneumonia had a worse outcome than seronegative children, a difference that is rendered statistically insignificant by the small sample size.

Increased disease burden and antibiotic resistance of bacteria causing severe community-acquired lower respiratory tract infections in human immunodeficiency virus type 1-infected children.

The changing spectrum of bacteria and antibiotic susceptibility patterns in HIV-1-infected children requires a reevaluation of the empirical treatment of community-acquired severe LRTI in children from developing countries with a high prevalence of childhood HIV- 1 infection.

Bacterial Disease and Antimicrobial Susceptibility Patterns in HIV-Infected, Hospitalized Children: A Retrospective Cohort Study

Bacterial infections are an important source of co-morbidity in HIV-infected children in resource-limited settings and clinicians should have a low threshold to initiate antibiotics in children requiring hospitalization.

Impact of tuberculosis preventive therapy on tuberculosis and mortality in HIV-infected children.

Isoniazid prophylaxis in HIV-infected children has the potential to play a major public health role by reducing TB incidence and death, and data are insufficient to guide the duration of proprylaxis and to support its use in children using highly active antiretroviral therapy (HAART) and in those living in areas of low TB prevalence.

Pneumococcal conjugate vaccine--a health priority.

  • H. ZarS. Madhi
  • Medicine, Biology
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
  • 2008
Cost-effectiveness analysis indicates that use of PCV is potentially highly cost-effective, at tiered pricing, even in very low-income countries.

Pathology and causes of death in a series of human immunodeficiency virus-positive and -negative pediatric referral hospital admissions in Botswana

Children ≤1 year who are known or suspected to be HIV-positive and who have cough, dyspnea and pulmonary infiltrates should be treated presumptively for PCP, as respiratory infection accounted for most deaths in HIV- positive children.

The Clinical Burden of Tuberculosis Among Human Immunodeficiency Virus-Infected Children in Western Kenya and the Impact of Combination Antiretroviral Treatment

These data suggest a high rate of TB diagnosis among HIV-infected children, with severe immune suppression, school attendance, orphan status, very low weight-for-height, and attending an urban clinic being key risk factors.

The Rate of Serious Bacterial Infections Among HIV-Infected Children With Immune Reconstitution Who Have Discontinued Opportunistic Infection Prophylaxis

OI or PCP prophylaxis can be withdrawn safely for HIV-infected pediatric patients who experience CD4+ cell recovery while receiving stable antiretroviral therapy, and more studies are needed to assess the association between antibody responses to neoantigens and the development of SBIs.