Survival of HIV-1 and HIV-2 perinatally infected children in The Gambia.
BACKGROUND
The risk of mother-to-child transmission (MTCT) of HIV-2 is much lower than that of HIV-1, but the long-term prognosis of perinatally infected HIV-2 children is unknown. We re-visited children who were part of a large MTCT study in The Gambia (conducted during 1993-1997), in order to compare the long-term survival of children perinatally infected with HIV-2 with that of seronegative and of HIV-1 infected children.


METHODS
Five to eight years' follow-up of a cohort of children born to HIV-negative, HIV-1 positive, and HIV-2 positive mothers.


RESULTS
Seven hundred and seventy-four children were followed up for a median of 6.6 years. Of 17 perinatally HIV-1 infected children, three were still alive on 1 July 2001, two had been lost to follow-up, and 12 had died. The median survival was 2.5 years. Of eight HIV-2 infected children five were still alive, none were lost to follow-up and three had died. The mortality hazards ratio of both HIV-1 [9.9; 95% confidence interval (CI), 5.2-19], and of HIV-2 infected children (3.9; CI, 1.2-12) was significantly increased compared with children of seronegative mothers. The mortality hazards ratio of HIV uninfected children of HIV-1 or HIV-2 infected mothers was not significantly increased compared to that of children of seronegative mothers (P = 0.17 and P = 0.5 respectively).


CONCLUSIONS
Children with perinatally acquired HIV-2 infection have a higher mortality than children of seronegative mothers. Guidelines for treatment of HIV-1 infected children should be used for treatment of HIV-2 infected children.
Schim van der Loeff
Maarten F
MF
Medical Research Council Laboratories, Fajara, The Gambia.
Hansmann
Andreas
A
Awasana
Akum Aveika
AA
Ota
Martin O
MO
O'Donovan
Diarmuid
D
Sarge-Njie
Ramu
R
Ariyoshi
Koya
K
Milligan
Paul
P
Whittle
Hilton
H
D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D005714:Gambia / Q000453:epidemiology; D015658:HIV Infections / Q000401:mortality* / Q000635:transmission; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011379:Prognosis; D016019:Survival Analysis