Disease progression among HIV-infected children who receive perinatal zidovudine prophylaxis.
BACKGROUND
Studies of perinatal HIV infection have reported mixed results regarding the prognosis of HIV-infected infants exposed to perinatal zidovudine prophylaxis (PZP).


METHODS
We have followed a population-based cohort of children with perinatal HIV infection to evaluate whether early HIV disease progression was more common among those who received PZP and whether subsequent antiretroviral therapy (ART) was less effective in preventing early disease progression.


RESULTS
We identified 73 children with perinatal HIV infection born between 1994 and 2001 with at least 3 years of follow-up and with information concerning PZP administration. Children who received PZP started subsequent ART at an earlier age than those who did not receive PZP (median age at starting treatment: 2 months for PZP vs. 6 months for no PZP; P = 0.0002). PZP was associated with decreased early HIV progression: 21% (7 of 33) of children who received PZP progressed to a category C diagnosis by 3 years compared with 45% (18 of 40) of children who did not receive PZP (P = 0.047). Children who did not receive PZP progressed to a category C diagnosis at a younger age than children who received PZP (median: 4 vs. 11 months; P = 0.061). ART was as effective in preventing early HIV progression in children who received PZP as in children who did not receive PZP.


CONCLUSIONS
In our population-based cohort of perinatally HIV-infected children, those who received PZP started ART at a significantly earlier age than those who did not receive PZP and also demonstrated decreased HIV disease progression by the age of 3 years.
Berk
David R
DR
Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305-5208, USA.
Falkovitz-Halpern
Meira S
MS
Sullivan
Barbara
B
Ruiz
Juan
J
Maldonado
Yvonne A
YA
D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology / Q000503:physiopathology* / Q000635:transmission; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D015215:Zidovudine / Q000008:administration & dosage* / Q000627:therapeutic use*
D015215:Zidovudine