Usefulness of chest physiotherapy with positive expiratory pressure (PEP)-mask in HIV-infected children with recurrent pulmonary infections.

Eight children with human immunodeficiency virus (HIV) and recurrent bacterial pulmonary infections were treated using a Positive Expiratory Pressure (PEP)-mask twice a day for 12 months. At the end of the study, a reduction in the number of pulmonary infections [mean (SD) 2.1 (0.9) vs 4.5 (1) p < 0.0001] and antibiotic courses [mean (SD) 1.5 (0.7) vs 2.4 (0.9) p < 0.021] was noted. The PEP-mask is a chest physiotherapy technique for removing infected secretions and optimizing airway functions that is also useful in HIV-infected children.

Granulocyte-colony stimulating factor and erythropoietin therapy in children with human immunodeficiency virus infection.

To determine whether granulocyte-colony stimulating factor and erythropoietin are effective in the therapy of neutropenia and anaemia related to human immunodeficiency virus (HIV) infection and to anti-retroviral agents, we recruited 11 HIV-infected children (mean age 4 years 10 months). All the children were given granulocyte-colony stimulating factor at a dosage of 5 micrograms/kg twice or three times a week while erythropoietin was administered additionally to three patients at a dosage of 50 U/kg twice a week. Both agents were administered subcutaneously for at least 4 months. Leukocyte and neutrophil counts significantly increased during the treatment (after 1 months, P = 0.003 and P = 0.009, respectively). Erythropoietin prevented blood transfusions and increased haemoglobin levels in the three children treated. No side-effects were recorded during the administration of either agent. Granulocyte-colony stimulating factor and erythropoietin appear to be safe and useful agents in the management of HIV-infected children.