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Temporal Trends in Mucocutaneous Findings Among Human Immunodeficiency Virus 1‐Infected Children in a Population‐Based Cohort
Author(s) -
Sturt Amy S.,
Anglemyer Andrew,
Berk David R.,
Maldonado Yvonne A.
Publication year - 2012
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12020
Subject(s) - medicine , mucocutaneous zone , cohort , pediatrics , population , cohort study , prospective cohort study , disease , environmental health
The objective of the study was to determine the prevalence of pediatric human immunodeficiency virus 1 ( HIV ‐1) mucocutaneous manifestations in the era of highly active antiretroviral therapy ( HAART ). We conducted population‐based, prospective, multicenter pediatric HIV ‐1 surveillance in 276 children with perinatally acquired HIV ‐1 from 1988 to 2009. Centers for Disease Control and Prevention ( CDC )‐defined HIV‐1 related mucocutaneous conditions among the 276 children were: category A ( n = 152), B ( n = 60), and C ( n = 1). Nearly half of the category A and B diagnoses (43.4% [66/152] and 35.0% [21/60], respectively) occurred in the first year of life, with 59.2% (90/152) and 61.7% (37/60), respectively, occurring in the first 2 years of life. The most frequent infectious diagnosis was oropharyngeal thrush ( n = 117, 42.4%); the most common inflammatory diagnosis was diaper dermatitis ( n = 71, 25.7%). There was a temporal decline in the prevalence of A (pre‐ HAART cohort, 123; post‐ HAART cohort, 29; p < 0.01) and B (pre‐ HAART , 55; post‐ HAART , 5; p < 0.01) mucocutaneous diagnoses. In children with perinatal HIV ‐1, there was a significant decline in CDC category A and B mucocutaneous diagnoses by temporal cohort, consistent with the introduction of antiretroviral medications and HAART . Clinical category A and B mucocutaneous diagnoses were most common in the first 2 years of life, emphasizing the importance of early HIV ‐1 testing and HAART initiation.