ABSTRACT
BACKGROUND: The Pediatric Spectrum of HIV Diseases (PSD) project has been collecting data on HIV-exposed children in Texas since 1989. These data have now been analyzed to describe mother-to-child transmission in Texas and to provide much needed information on the magnitude of the pediatric HIV epidemic in the state. METHODS: We examined trends in the numbers of perinatally exposed children and perinatally acquired cases of HIV in the Texas PSD cohort. We calculated transmission rates and relative risks for 656 children born from January, 1995, to July, 1998, that received all or part of the ACTG 076 regimen. RESULTS: Only a small proportion (38%) of pairs of an HIV-infected mother and her HIV-exposed child received the full AIDS Clinical Trial Group 076 (ACTG 076) regimen; only 73% of the mothers received at least some prenatal care. In recent years, however, the numbers of perinatally exposed children and perinatally acquired cases of HIV have decreased in Texas. Univariate analyses showed that a reduction in the vertical transmission of HIV was associated with receipt of a full ACTG 076 regimen, receipt of a partial ACTG 076 regimen and residence in Dallas County. CONCLUSIONS: Findings identify a gap in meeting the health care needs of pregnant HIV-infected women and suggest missed opportunities to prevent mother-to-child transmission of HIV. At the same time this study confirms progress in prevention efforts to reduce mother-to-child transmission of HIV in Texas.
Subject(s)
HIV Infections/transmission , Infectious Disease Transmission, Vertical , Anti-HIV Agents/therapeutic use , Female , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Male , Pregnancy , Pregnancy Complications, Infectious , Prenatal Care , Risk Factors , Texas/epidemiology , Zidovudine/therapeutic useSubject(s)
Brain/diagnostic imaging , Candidiasis/complications , Candidiasis/diagnostic imaging , Hydrocephalus/diagnostic imaging , Hydrocephalus/etiology , Antifungal Agents/therapeutic use , Brain/microbiology , Brain/surgery , Candidiasis/microbiology , Humans , Hydrocephalus/therapy , Infant , Male , Tomography, X-Ray ComputedSubject(s)
Acquired Immunodeficiency Syndrome/complications , HIV Infections/complications , Lung Diseases/complications , Opportunistic Infections/complications , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use , Bacterial Infections/complications , Bacterial Infections/diagnosis , Bacterial Infections/drug therapy , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Lung Diseases/diagnosis , Lung Diseases/drug therapy , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Mycoplasma Infections/complications , Mycoplasma Infections/diagnosis , Mycoplasma Infections/drug therapy , Mycoses/complications , Mycoses/diagnosis , Mycoses/drug therapy , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Pneumonia, Pneumocystis/complications , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/drug therapy , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/drug therapy , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Virus Diseases/complications , Virus Diseases/diagnosis , Virus Diseases/drug therapySubject(s)
Acquired Immunodeficiency Syndrome/complications , Brain Diseases/complications , HIV Infections/complications , Acquired Immunodeficiency Syndrome/psychology , Brain Diseases/psychology , Child, Preschool , Cryptococcosis/complications , Developmental Disabilities/complications , HIV Infections/psychology , Humans , Infant , Meningitis/complications , Psychological Tests , Syphilis/complications , Toxoplasmosis/complications , Virus Diseases/complicationsSubject(s)
HIV Infections/complications , Infections/complications , Acute Disease , Central Nervous System Diseases/complications , Child , Child, Preschool , Gastrointestinal Diseases/complications , Humans , Infant , Infant, Newborn , Pneumonia/complications , Skin Diseases, Infectious/complicationsSubject(s)
Child Abuse, Sexual/diagnosis , Chlamydia trachomatis/isolation & purification , Urogenital System/microbiology , Child , Child, Preschool , Chlamydia Infections/epidemiology , Chlamydia Infections/microbiology , Female , Fluorescent Antibody Technique , Humans , Infant , Male , Predictive Value of Tests , Prospective StudiesABSTRACT
Epithelial manifestations as indicators of group B streptococcal (GBS) bacteremia have been infrequently reported in the literature. This report describes three infants, ranging in age from 2 1/2 weeks to 7 weeks, who were seen with facial cellulitis as the only sign of GBS bacteremia. Only one of these infants had fever on presentation; otherwise, there were no signs of systemic illness. "Spontaneous cellulitis" should be viewed as an indicator of underlying bacteremia; in an infant less than 3 months of age, GBS should be considered a prime etiologic agent.
