HIV Flashcards
What is the most common complication in HIV-infected children?
Respiratory disease
WHO guidelines now recommend ART initiation early in all children and adolescents, with a particular focus on infants.
How much higher is the risk of pneumonia in HIV-infected children compared to HIV-uninfected children?
6x higher rate of hospitalization or death.
What are the most common respiratory infections in ART-naïve children?
- Bacterial pneumonia – 25%
- PTB – 10%
What is the effect of ART on different types of respiratory infections?
- EPTB – 85% reduction
- PTB – 60% reduction
- PCP – 30% reduction
- Bacterial pneumonia – 15% reduction
When does the highest incidence of pneumonia occur in HIV-infected children?
In infancy, especially in the first 6 months of life.
What is the most common lower respiratory tract infection (LRTI) in both ART-naïve and ART-exposed children?
Bacterial pneumonia.
What role does immunization with PCV and Hib play in HIV-infected children?
Provides protection against specific bacterial infections.
What is the recommended prophylactic treatment in older children after 2 years on ART?
Continuing CTX prophylaxis.
How does HIV infection predispose individuals to tuberculosis (TB)?
Worsens immunosuppression and hastens progression to AIDS.
What is the recommended screening for HIV-infected children regarding TB?
Annual screening for M. tuberculosis infection.
What indicates a positive PPD reaction in HIV-infected children?
A reaction > 5 mm.
What is the sensitivity of blood interferon (IFN) gamma assay compared to PPD for diagnosing M. tuberculosis in HIV-infected children?
Higher sensitivity and specificity.
What is the first line investigation for suspected HIV-associated TB?
Xpert.
What is the recommended therapy for PTB in HIV-infected children?
Empiric therapy should include four drugs.
What is the effect of primary isoniazid (INH) prophylaxis in HIV-infected children?
- Reduces mortality by approximately 50%
- Reduces TB incidence by approximately 70%
What is contraindicated in HIV-infected children regarding the BCG vaccine?
Due to the high risk of developing disseminated disease and of death.
What is the prognosis for patients with disseminated MAC?
Poor prognosis.
What is the minimum number of agents recommended for prophylaxis and therapy for disseminated MAC?
Use a minimum of 2 agents.
What is the recommended primary prophylaxis for severely immunosuppressed children with CD4+ cell counts?
- < 50/μL if older than 6 years
- < 75/μL if 2–6 years
- < 500/μL if 1–2 years
- < 750/μL if younger than 1 y/o
What virus predominates in viral infections among HIV-infected children?
RSV.
What are the common viral infections in HIV-infected children?
- Influenza
- Parainfluenza
- Human metapneumovirus
- Adenovirus
What is the treatment of choice for Pneumocystis jirovecii pneumonia (PCP)?
High-dose IV CTX (trimethoprim-sulfamethoxazole [TMP-SMX]).
What indicates the need for mechanical ventilation in PCP cases?
High rate of respiratory failure.
What is the recommended prophylaxis for PCP in infants born to HIV-infected mothers?
Beginning at 4–6 weeks of age.
