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Section 2
Section 3
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Appendices

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Section 3. Summaries of Infectious Diseases

Human Immunodeficiency Virus Infection 1

Clinical Manifestations
Etiology
Epidemiology
Incubation Period
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Human immunodeficiency virus (HIV) infection in children and adolescents causes a broad spectrum of disease manifestations and a varied clinical course. Acquired immunodeficiency syndrome (AIDS) represents the most severe end of the clinical spectrum. Surveillance definitions of the Centers for Disease Control and Prevention (CDC) for AIDS in adults and adolescents are listed in Table 3.23 (p 379), and the CDC clinical categories and pediatric classification system for children younger than 13 years of age who are born to HIV-infected mothers or who are known to be infected with HIV are presented in Tables 3.24 (p 380) and 3.25 (p 382). 2 3 This pediatric classification system, which was established for surveillance of HIV infection, emphasizes the importance of the CD4+ T-lymphocyte count as an immunologic surrogate and marker of prognosis but does not use information on viral load as quantitated by HIV RNA polymerase chain reaction (PCR) assay.


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  		Table 3.23. 1993 Revised Case Definition of AIDS-Defining Conditions for Adults and Adolescents 13 Years of Age and Older1

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  		Table 3.24. Clinical Categories for Children Younger Than 13 Years of Age With Human Immunodeficiency Virus (HIV) Infection1

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  		Table 3.25. Pediatric Human Immunodeficiency Virus (HIV) Classification for Children Younger Than 13 Years of Age1

Manifestations of pediatric HIV infection include generalized lymphadenopathy, hepatomegaly, splenomegaly, failure to thrive, oral candidiasis, recurrent diarrhea, parotitis, cardiomyopathy, hepatitis, nephropathy, central nervous system (CNS) disease (including microcephaly, hyperreflexia, clonus, and developmental delay), lymphoid interstitial pneumonia, . . . [Go to Full Text]


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  • Sanchez-Ramon, S., Ma Bellon, J., Resino, S., Canto-Nogues, C., Gurbindo, D., Ramos, J.-T., Munoz-Fernandez, M. (2003). Low Blood CD8+ T-Lymphocytes and High Circulating Monocytes Are Predictors of HIV-1-Associated Progressive Encephalopathy in Children. Pediatrics 111: e168-175 [Abstract] [Full Version]  
  • Scherpbier, H. J., Bekker, V., van Leth, F., Jurriaans, S., Lange, J. M.A., Kuijpers, T. W. (2006). Long-term Experience With Combination Antiretroviral Therapy That Contains Nelfinavir for up to 7 Years in a Pediatric Cohort. Pediatrics 117: e528-e536 [Abstract] [Full Version]  
  • Freeman, J. M. (2003). Less Testing Is Needed in the Emergency Room After a First Afebrile Seizure. Pediatrics 111: 194-196 [Full Version]  
  • Church, J. A. (2002). Lamivudine-Zidovudine Combination for Prevention of Maternal-Infant Transmission of HIV-1. Pediatrics 110: 469-470 [Full Version]  
  • Church, J. A. (2004). LONGITUDINAL ANALYSIS OF HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 RNA IN BREAST MILK AND OF ITS RELATIONSHIP TO INFANT INFECTION AND MATERNAL DISEASE. Pediatrics 114: 552-552 [Full Version]  
  • Church, J. A. (2004). LETHAL T CELL IMMUNODEFICIENCY INDUCED BY CHRONIC COSTIMULATION VIA CD27-CD70 INTERACTIONS. Pediatrics 114: 552-553 [Full Version]  
  • Schoen, E. J. (2003). It's Wise to Circumcise: Time to Change Policy. Pediatrics 111: 1490-1491 [Full Version]  
  • Bellamy, C. (2004). International Pediatric Congress. Pediatrics 114: 1088-1089 [Full Version]  
  • Hammami, N., Nostlinger, C., Hoeree, T., Lefevre, P., Jonckheer, T., Kolsteren, P. (2004). Integrating Adherence to Highly Active Antiretroviral Therapy Into Children's Daily Lives: A Qualitative Study. Pediatrics 114: e591-e597 [Abstract] [Full Version]  
  • Buchacz, K., Cervia, J. S., Lindsey, J. C., Hughes, M. D., Seage III, G. R., Dankner, W. M., Oleske, J. M., Moye, J., for the Pediatric AIDS Clinical Trials Group 219 S, (2001). Impact of Protease Inhibitor-Containing Combination Antiretroviral Therapies on Height and Weight Growth in HIV-Infected Children. Pediatrics 108: e72-72 [Abstract] [Full Version]  
  • McComsey, G., Bhumbra, N., Ma, J.-F., Rathore, M., Alvarez, A. (2003). Impact of Protease Inhibitor Substitution With Efavirenz in HIV-Infected Children: Results of the First Pediatric Switch Study. Pediatrics 111: e275-281 [Abstract] [Full Version]  
  • Schoen, E. J. (2006). Ignoring Evidence of Circumcision Benefits. Pediatrics 118: 385-387 [Full Version]  
  • Committee on Pediatric AIDS, (2000). Identification and Care of HIV-Exposed and HIV-Infected Infants, Children, and Adolescents in Foster Care. Pediatrics 106: 149-153 [Abstract] [Full Version]  
  • Church, J. A. (2003). INCIDENCE OF CARDIAC ABNORMALITIES IN CHILDREN WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION: THE PROSPECTIVE P2C2 HIV STUDY. Pediatrics 112: 491-491 [Full Version]  
  • Noguera, A., Fortuny, C., Munoz-Almagro, C., Sanchez, E., Vilaseca, M. A., Artuch, R., Pou, J., Jimenez, R. (2004). Hyperlactatemia in Human Immunodeficiency Virus-Uninfected Infants Who Are Exposed to Antiretrovirals. Pediatrics 114: e598-e603 [Abstract] [Full Version]  
  • Read, J. S., Committee on Pediatric AIDS, (2003). Human Milk, Breastfeeding, and Transmission of Human Immunodeficiency Virus Type 1 in the United States. Pediatrics 112: 1196-1205 [Abstract] [Full Version]  
  • Langston, C., Cooper, E. R., Goldfarb, J., Easley, K. A., Husak, S., Sunkle, S., Starc, T. J., Colin, A. A., for the P2C2 HIV Study Group, (2001). Human Immunodeficiency Virus-Related Mortality in Infants and Children: Data From the Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV (P2C2) Study. Pediatrics 107: 328-338 [Abstract] [Full Version]  
  • Church, J. A. (2005). Human Immunodeficiency Virus-Driven Expansion of CD4+CD25+ Regulatory T Cells, Which Suppress HIV-Specific CD4 T-Cell Responses in HIV-Infected Patients. Pediatrics 116: 572-572 [Full Version]  
  • Merchant, R. C., Keshavarz, R. (2001). Human Immunodeficiency Virus Postexposure Prophylaxis for Adolescents and Children. Pediatrics 108 : e38-e38 [Abstract] [Full Version]  
  • Kemper, K. J. (2000). Holistic Pediatrics = Good Medicine. Pediatrics 105: 214-218 [Full Version]  
  • Mellins, C. A., Smith, R., O'Driscoll, P., Magder, L. S., Brouwers, P., Chase, C., Blasini, I., Hittleman, J., Llorente, A., Matzen, E. (2003). High Rates of Behavioral Problems in Perinatally HIV-Infected Children Are Not Linked to HIV Disease. Pediatrics 111: 384-393 [Abstract] [Full Version]  
  • The European Collaborative Study, (2003). Height, Weight, and Growth in Children Born to Mothers With HIV-1 Infection in Europe. Pediatrics 111: e52-60 [Abstract] [Full Version]  
  • Bagenda, D., Nassali, A., Kalyesubula, I., Sherman, B., Drotar, D., Boivin, M. J., Olness, K. (2006). Health, Neurologic, and Cognitive Status of HIV-Infected, Long-Surviving, and Antiretroviral-Naive Ugandan Children. Pediatrics 117: 729-740 [Abstract] [Full Version]  
  • Miller, L. C., Hendrie, N. W. (2000). Health of Children Adopted From China. Pediatrics 105: 76e-76 [Abstract] [Full Version]  
  • McCormick, M. C., Stoto, M. A. (2000). HIV Screening. Pediatrics 105: 1375-1375 [Full Version]  
  • Sia, J., Paul, S., Martin, R. M., Cross, H. (2004). HIV Infection and Zidovudine Use in Childbearing Women. Pediatrics 114: e707-e712 [Abstract] [Full Version]  
  • Church, J. A. (2005). Growth Hormone in T-Lymphocyte Thymic and Postthymic Development: A Study in HIV-Infected Children. Pediatrics 116: 571-572 [Full Version]  
  • Taha, T. E., Nour, S., Kumwenda, N. I., Broadhead, R. L., Fiscus, S. A., Kafulafula, G., Nkhoma, C., Chen, S., Hoover, D. R. (2005). Gender Differences in Perinatal HIV Acquisition Among African Infants. Pediatrics 115: e167-e172 [Abstract] [Full Version]  
  • Foca, M., Moye, J., Chu, C., Matthews, Y., Rich, K., Handelsman, E., Luzuriaga, K., Paul, M., Diaz, C., Women and Infants Transmission Study, (2006). Gender Differences in Lymphocyte Populations, Plasma HIV RNA Levels, and Disease Progression in a Cohort of Children Born to Women Infected With HIV. Pediatrics 118: 146-155 [Abstract] [Full Version]  
  • Shingadia, D., Viani, R. M., Yogev, R., Binns, H., Dankner, W. M., Spector, S. A., Chadwick, E. G. (2000). Gastrostomy Tube Insertion for Improvement of Adherence to Highly Active Antiretroviral Therapy in Pediatric Patients With Human Immunodeficiency Virus. Pediatrics 105: 80e-80 [Abstract] [Full Version]  
  • The European Collaborative Study, (2001). Fluctuations in Symptoms in Human Immunodeficiency Virus-Infected Children: The First 10 Years of Life. Pediatrics 108: 116-122 [Abstract] [Full Version]  
  • Murphy, D. A., Mitchell, R., Vermund, S. H., Futterman, D. (2002). Factors Associated With HIV Testing Among HIV-Positive and HIV-Negative High-Risk Adolescents: The REACH Study. Pediatrics 110: e36-36 [Abstract] [Full Version]  
  • Church, J. A. (2004). FAILURE OF 1 WEEK ON/1 WEEK OFF ANTIRETROVIRAL THERAPIES IN A RANDOMIZED TRIAL. Pediatrics 114: 551-551 [Full Version]  
  • King, S. M., Committee on Pediatric AIDS, , Canadian Paediatric Society, Infectious Diseases a, (2004). Evaluation and Treatment of the Human Immunodeficiency Virus-1--Exposed Infant. Pediatrics 114: 497-505 [Abstract] [Full Version]  
  • Oaklander, A. (2005). Erythromelalgia: Small-Fiber Neuropathy by Any Other Name?. Pediatrics 116: 293-294 [Full Version]  
  • Smith, R., Malee, K., Leighty, R., Brouwers, P., Mellins, C., Hittelman, J., Chase, C., Blasini, I., for the Women and Infants Transmission Study Group, (2006). Effects of Perinatal HIV Infection and Associated Risk Factors on Cognitive Development Among Young Children. Pediatrics 117: 851-862 [Abstract] [Full Version]  
  • Howland, L. C., Gortmaker, S. L., Mofenson, L. M., Spino, C., Gardner, J. D., Gorski, H., Fowler, M. G., Oleske, J. (2000). Effects of Negative Life Events on Immune Suppression in Children and Youth Infected With Human Immunodeficiency Virus Type 1. Pediatrics 106: 540-546 [Abstract] [Full Version]  
  • Church, J. (2002). Effective Combination Therapy Including Protease Inhibitors on Mortality Among Children and Adolescents Infected with HIV-1. Pediatrics 110: 469-469 [Full Version]  
  • McGrath, N., Bellinger, D., Robins, J., Msamanga, G. I., Tronick, E., Fawzi, W. W. (2006). Effect of Maternal Multivitamin Supplementation on the Mental and Psychomotor Development of Children Who Are Born to HIV-1-Infected Mothers in Tanzania. Pediatrics 117: e216-e225 [Abstract] [Full Version]  
  • Committee on Pediatric AIDS, (2000). Education of Children With Human Immunodeficiency Virus Infection. Pediatrics 105: 1358-1360 [Abstract] [Full Version]  
  • Chase, C., Ware, J., Hittelman, J., Blasini, I., Llorente, A., Anisfeld, E., Diaz, C., Fowler, M. G., Moye, J., Kaligh, L. I., for the Women and Infants Transmission Study Group, (2000). Early Cognitive and Motor Development Among Infants Born to Women Infected With Human Immunodeficiency Virus. Pediatrics 106: 25e-25 [Abstract] [Full Version]  
  • Church, J. A. (2003). EFFECTIVENESS OF COL-1492, A NONOXYNOL-9 VAGINAL GEL, ON HIV-1 TRANSMISSION IN FEMALE SEX WORKERS: A RANDOMISED, CONTROLLED TRIAL. Pediatrics 112: 491-491 [Full Version]  
  • Araújo, A. P. d. Q. C., Nascimento, O. J. M., Garcia, O. S. (2000). Distal Sensory Polyneuropathy in a Cohort of HIV-Infected Children Over Five Years of Age. Pediatrics 106: 35e-35 [Abstract] [Full Version]  
  • Kramer, J. M., LaRussa, P., Tsai, W. C., Carney, P., Leber, S. M., Gahagan, S., Steinberg, S., Blackwood, R. A. (2001). Disseminated Vaccine Strain Varicella as the Acquired Immunodeficiency Syndrome-Defining Illness in a Previously Undiagnosed Child. Pediatrics 108 : e39-e39 [Abstract] [Full Version]  
  • Kline, M. W., O'Connor, K. G. (2003). Disparity Between Pediatricians' Knowledge and Practices Regarding Perinatal Human Immunodeficiency Virus Counseling and Testing. Pediatrics 112: e367-367 [Abstract] [Full Version]  
  • Stiehm, E. R. (2006). Disease Versus Disease: How One Disease May Ameliorate Another. Pediatrics 117: 184-191 [Abstract] [Full Version]  
  • Decker, M. R., Silverman, J. G., Raj, A. (2005). Dating Violence and Sexually Transmitted Disease/HIV Testing and Diagnosis Among Adolescent Females. Pediatrics 116: e272-e276 [Abstract] [Full Version]  
  • Silverman, J. G., Raj, A., Clements, K. (2004). Dating Violence and Associated Sexual Risk and Pregnancy Among Adolescent Girls in the United States. Pediatrics 114: e220-e225 [Abstract] [Full Version]  
  • Immergluck, L. C., Cull, W. L., Schwartz, A., Elstein, A. S. (2000). Cost-Effectiveness of Universal Compared With Voluntary Screening for Human Immunodeficiency Virus Among Pregnant Women in Chicago. Pediatrics 105: 54e-54 [Abstract] [Full Version]  
  • Friday, G. A. Jr (2002). Coparent or Second-Parent Adoption by Same-Sex Parents. Pediatrics 109: 1192-1193 [Full Version]  
  • Wertlieb, D. (2003). Converging Trends in Family Research and Pediatrics: Recent Findings for the American Academy of Pediatrics Task Force on the Family. Pediatrics 111: 1572-1587 [Full Version]  
  • McKinney, R. E. Jr (2003). Congress, the FDA, and the Fair Development of New Medications for Children. Pediatrics 112: 669-670 [Full Version]  
  • Committee on Adolescence, (2001). Condom Use by Adolescents. Pediatrics 107: 1463-1469 [Abstract] [Full Version]  
  • Becquet, R., Leroy, V., Ekouevi, D. K., Viho, I., Castetbon, K., Fassinou, P., Dabis, F., Timite-Konan, M., ANRS 1201/1202 Ditrame Plus Study Group, (2006). Complementary Feeding Adequacy in Relation to Nutritional Status Among Early Weaned Breastfed Children Who Are Born to HIV-Infected Mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire. Pediatrics 117: e701-e710 [Abstract] [Full Version]  
  • Tamula, M. A. T., Wolters, P. L., Walsek, C., Zeichner, S., Civitello, L. (2003). Cognitive Decline With Immunologic and Virologic Stability in Four Children With Human Immunodeficiency Virus Disease. Pediatrics 112: 679-684 [Abstract] [Full Version]  
  • Darville, T., Wheeler, J. G., Tucker, N. C., Hackler, C., Young, K., Maples, H. D. (2005). Coercive Treatment of HIV-Positive Children Is Not Justified: In Reply. Pediatrics 116: 1606-1608 [Full Version]  
  • Crowe, D., De Matteo, D., Irwin, M., Kent, G., McClain, V. (2005). Coercive Treatment of HIV-Positive Children Is Not Justified. Pediatrics 116: 1605-1606 [Full Version]  
  • Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., Anda, R. F. (2003). Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study. Pediatrics 111: 564-572 [Abstract] [Full Version]  
  • Dubowitz, H., Papas, M. A., Black, M. M., Starr, R. H. Jr (2002). Child Neglect: Outcomes in High-Risk Urban Preschoolers. Pediatrics 109: 1100-1107 [Abstract] [Full Version]  
  • Church, J. A. (2003). CONTRIBUTION OF HUMAN {alpha}-DEFENSIN 1, 2, AND 3 TO THE ANTI-HIV-1 ACTIVITY OF CD8 ANTIVIRAL FACTOR. Pediatrics 112: 490-490 [Full Version]  
  • Church, J. A. (2005). CD4+ T Cell Depletion During All Stages of HIV Disease Occurs Predominantly in the Gastrointestinal Tract. Pediatrics 116: 572-573 [Full Version]  
  • Church, J. A. (2004). BROAD ANTIRETROVIRAL DEFENSE BY HUMAN APOBEC3G THROUGH LETHAL EDITING OF NASCENT REVERSE TRANSCRIPTS. Pediatrics 114: 552-552 [Full Version]  
  • (2002). Analysis of Oral Polio Vaccine Chat Stocks. Pediatrics 110: 468-468 [Full Version]  
  • Shearer, W. T., Lipshultz, S. E., Easley, K. A., McIntosh, K., Pitt, J., Quinn, T. C., Kattan, M., Goldfarb, J., Cooper, E., Bryson, Y., Kovacs, A., Bricker, J. T., Peavy, H., Mellins, R. B., for the Pediatric Pulmonary and Cardiovascular Com, , Heart, N., Institute, L. a. B. (2000). Alterations in Cardiac and Pulmonary Function in Pediatric Rapid Human Immunodeficiency Virus Type 1 Disease Progressors. Pediatrics 105: e9-e9 [Abstract] [Full Version]  
  • Committee on Pediatric AIDS and Committee on Adole, (2001). Adolescents and Human Immunodeficiency Virus Infection: The Role of the Pediatrician in Prevention and Intervention. Pediatrics 107: 188-190 [Abstract] [Full Version]  
  • Aggarwal, M., Rein, J. (2003). Acute Human Immunodeficiency Virus Syndrome in an Adolescent. Pediatrics 112: e323-323 [Abstract] [Full Version]  
  • Church, J. A (2003). ANTIRETROVIRAL-DRUG RESISTANCE AMONG PATIENTS RECENTLY INFECTED WITH HIV. Pediatrics 112: 492-492 [Full Version]  
  • American Academy of Pediatrics, (2006). AAP Publications Retired and Reaffirmed. Pediatrics 117: 1846-1847 [Full Version]  
  • American Academy of Pediatrics, (2005). AAP Publications Retired and Reaffirmed. Pediatrics 116: 796-796 [Full Version]  
  • American Academy of Pediatrics, (2005). AAP Publications Retired and Reaffirmed. Pediatrics 115: 1438-1438 [Full Version]  
  • Sáez-Llorens, X., Nelson Jr, R. P., Emmanuel, P., Wiznia, A., Mitchell, C., Church, J. A., Sleasman, J., Van Dyke, R., Richardson, C. G., Cutrell, A., Spreen, W., Hetherington, S., the CNAA3006 Study Team, (2001). A Randomized, Double-Blind Study of Triple Nucleoside Therapy of Abacavir, Lamivudine, and Zidovudine Versus Lamivudine and Zidovudine in Previously Treated Human Immunodeficiency Virus Type 1-Infected Children. Pediatrics 107: 4e-4 [Abstract] [Full Version]  
  • Nozyce, M. L., Lee, S. S., Wiznia, A., Nachman, S., Mofenson, L. M., Smith, M. E., Yogev, R., McIntosh, K., Stanley, K., Pelton, S. (2006). A Behavioral and Cognitive Profile of Clinically Stable HIV-Infected Children. Pediatrics 117: 763-770 [Abstract] [Full Version]