PAEDIATRIC CARE

Dramatic decline in mortality, disease progression and hospital admissions in children with HIV infection in the UK and Ireland

Gareth Tudor-Williams, for HIV i-Base

Dr. Di Gibb and colleagues from the Collaborative HIV Paediatric Study group have published evidence showing a dramatic decline in childrens mortality and disease progression, gathered from 944 perinatally infected children.

Mortality rates fell from 9.2 per hundred-child-years-at risk in the pre-combination ART era (before 1997) to 1.2–2.0 in the years 2000 – 2002. A 50% reduction in disease progression to Category C disease (AIDS-defining illnesses) and an 80% reduction in hospital admission rates were observed over the same period.

An obvious implication of this improved survival is that increasing numbers of children with perinatally acquired HIV are now entering their teens and are expected to survive into adulthood. Specialist adolescent services need to be developed, and GU physicians should anticipate young people with complex treatment histories making the transition to their services.

Ref: Gibb DM, et al. Decline in mortality, AIDS and hospital admissions in perinatally HIV-1 infected children in the United Kingdom and Ireland. BMJ 2003: 327; 1019-1022.

	HIV Treatment Bulletin Vol 4 No 10 December / January 2003 / 2004