부산대학교 도서관

Infection with human immunodeficiency virus type I (HIV-I) is often complicated by Pneumocystis carinii pneumonia (PCP), which is associated with high rates of death and disability. PCP is often the initial sign of HIV disease in children who acquire HIV infection at birth. HIV-infected children may only survive for as little as one month after PCP diagnosis. Some factors that may predict the risk of developing PCP in adults include persistent thrush, or yeast infection of the mouth or throat; persistent elevated temperature; and decreased numbers of CD4 cells, a type of immune cell. Guidelines for use of PCP prophylaxis (preventive treatment) for HIV-infected adults have been developed by the United States Public Health Service. However, it remains unclear whether similar risk factors can be applied to HIV-infected children. Studies suggest that the numbers of lymphocytes, such as CD4 cells, are higher in infants as compared with adults. The characteristics of children who develop PCP, the associated clinical and laboratory findings, and the outcome of PCP in these children were assessed by reviewing 27 cases of pediatric AIDS-associated PCP. The mean (average) age at PCP diagnosis was 10.8 months, whereas the median (most frequent) age at diagnosis was 7.7 months. All infants had clinical evidence of HIV disease, which was detected before or during PCP diagnosis. Most cases were associated with acute illness, and 70 percent of infants developed complications of treatment. Seventy percent survived less than six months after PCP diagnosis. Most infants survived only two months after diagnosis, and the average life span of HIV-infected children with PCP was 14.4 months. Only 40 percent of children had CD4 lymphocyte counts that would be considered low enough to begin PCP prophylaxis in HIV-infected adults. (Consumer Summary produced by Reliance Medical Information, Inc.)