title: Clinical Outcomes and Hospitalizations among Children Perinatally Infected with HIV-1 in Baja California, Mexico.
abstract: This study characterizes temporal trends in HIV disease progression among perinatally infected children at a clinic in Baja California, Mexico. A total of 73 children were followed, 52% were categorized under US Centers for Disease Control and Prevention (CDC) classification group C with a mean age of 2.3 years (SD ± 3.16) at HIV diagnosis. For the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007, highly active antiretroviral therapy (HAART) use increased to 60%, 75%, 83%, and 94% (P < .001) as did mean CD4 percentage of 23.4%, 23.2%, 26.9%, and 29.0%, respectively (P = .009), while HIV plasma RNA log(10) decreased significantly (4.49, 4.23, 4.00, and 3.79, respectively; P = .019). Overall mortality was 31% (23 of 73), with pneumonia being the most common cause of death (43% of all deaths) followed by tuberculosis (22%). Mortality rates declined from 30.4% to 25%, 8.9%, and 9.3% (p = 0.035) for the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007, respectively. Kaplan-Meier survival analysis showed that median survival was 11.2 years; 1-, 2-, and 5-year survival was 87%, 83%, and 67%, respectively. These findings document a high but improving trend in morbidity and mortality of children perinatally infected with HIV in Tijuana, Baja California, Mexico.
authors.affiliation: 1Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, CA, USA.
authors.forename: Rolando M
authors.initials: RM
authors.lastname: Viani
authors.forename: Maria Rosario G
authors.initials: MR
authors.lastname: Araneta
authors.forename: Graciano
authors.initials: G
authors.lastname: Lopez
authors.forename: Enrique
authors.initials: E
authors.lastname: Chacón-Cruz
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Spector
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D002140:California; D002648:Child; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008800:Mexico