Publication Type:

Journal Article

Source:

Current HIV Research, Volume 6, Number 5, p.419-432 (2008)

URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-53849130648&partnerID=40&md5=54f5f2c545c3380b3d2a89cee512ea1c

Keywords:

abdominal pain, adolescent, amylase, anemia, angioneurotic edema, antibody detection, antiretrovirus agent, breast feeding, CD4+ T lymphocyte, child, childhood mortality, clinical feature, Clinical trial, comorbidity, diagnostic accuracy, diarrhea, didanosine, disease course, drug efficacy, drug eruption, drug safety, drug substitution, drug treatment failure, drug withdrawal, early diagnosis, efavirenz, EMBASE, epidemic, Epidemiology, failure to thrive, Fatty Liver, female, gastritis, genotype, hepatitis, hepatitis C, highly active antiretroviral therapy, HIV Infections, HIV-1, hospitalization, human, Human immunodeficiency virus, Human immunodeficiency virus antibody, Human immunodeficiency virus infection, Human immunodeficiency virus prevalence, Humans, incidence, India, infant, infection risk, lamivudine, lamivudine plus nevirapine plus stavudine, lamivudine plus stavudine, lamivudine plus zidovudine, liver enzyme, liver toxicity, male, malnutrition, MEDLINE, Molecular, molecular epidemiology, monotherapy, nevirapine, newborn, newborn screening, observational study, opportunistic infection, pancreatitis, population research, practice guideline, Preschool, prospective study, retrospective study, review, RNA directed DNA polymerase inhibitor, Sex Factors, sex ratio, short course therapy, side effect, single drug dose, stavudine, symptom, systematic review, thalassemia, Tuberculosis, unclassified drug, vertical transmission, virus resistance, virus transmission, zidovudine

Abstract:

Despite an estimated 70,000 Indian children living with HIV infection, little is known about India's pediatric HIV epidemic. Generalizations about epidemiology, natural history, and treatment outcomes from other resource-limited settings (RLS) may be inaccurate for several biologic and social reasons. A review of the Indian literature is needed to optimize country-specific HIV management and examine these generalizations. MEDLINE and EMBASE were searched for articles published in English by November 2007 on HIV-infected, Indian childr-en (0-18 years)that detailed epidemiology, natural history, or treatment. Articles with original, extractable data were selected and summarized using descriptive statistics. Of 370 citations, 58 studies were included in this review (median study size 24 children). Significant heterogeneity was noted among the studies. HIV infection was reported nearly twice as often in males (male/female ratio 1.9) and diagnosed earlier (4.7 years) than in other RLS. Over 2% of hospitalized children were reported to be HIV-infected. The reported mortality among HIV-infected newborns of 22% at 18 months was lower than other RLS. Improved anthropometrics were the only consistently reported and comparable benefit of short-term HAART to other RLS. Review of the Indian literature yielded potentially unique epidemiology and natural history compared to other RLS. However, important questions about the accuracy and representativeness of the Indian data limit its generalizability and comparability. Targeted interventions to curb India's pediatric HIV epidemic require urgent clarification of these findings. If such differences truly exist, management guidelines should be tailored accordingly. © 2008 Bentham Science Publishers Ltd.

Notes:

cited By (since 1996)5

Cite this Research Publication

H. Ka Singh, Gupta, Aa, Siberry, G. Kb, Gupte, Nc, Sastry, Jc, Kinikar, Ad, Shah, Ie, Gangakhedkar, R. Rf, Bollinger, R. Ca, and Kulkarni, Vg, “The Indian pediatric HIV epidemic: A systematic review”, Current HIV Research, vol. 6, pp. 419-432, 2008.