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Archivos argentinos de pediatría

Print version ISSN 0325-0075On-line version ISSN 1668-3501


LUEDICKE, Nora; PUEYO, Silvia T.; REZZONICO, Gabriela  and  LANCIERI, Irma. Evolución de la infección por virus varicela zósteren niños infectados perinatalmente conel virus de la inmunodeficiencia humana. Arch. argent. pediatr. [online]. 2004, vol.102, n.1, pp.18-21. ISSN 0325-0075.

Introduction. Children infected with HIV have an extremely high risk of developing zoster within a few months or a few years after primary infection with varicella zoster virus (VZV). Some authorshave observed serious complications due to VZV infections and recommended the treatment with IV acyclovir in these patients. Objective. 1) To estimate the incidence of VZV infection in perinatal HIV infection. 2) To determinethe clinical outcome of the VZV infection inperinatally HIV infected children related to their clinical and immunological status. 3) To establish the characteristics of the complications in those treated with oral or intravenous acyclovir and in non-medicated patients. Population, material and methods. Retrospective and observational study. We reviewed the charts of 60patients with perinatal HIV infection, followed up at our hospital between 1990 and 2001. The VZV infection diagnosis was based on clinical criteria. Varicella was considered as the first event and herpes zoster and recurrent varicella, as further events. In both groups of patients we analyzed the status of the disease (CDC/1994), as well as the most recent CD4 cell count. The occurrence of complications and their outcome related to the treatment with intravenous or oral acyclovir and in non medicated patients, was also assessed. We performed statistical analysis with estimation of averages and measures of central trend. When needed, confidence intervals (95%) were estimated. Results. Out of the 60 patients evaluated 33 (55%) had one or more events of VZV infection. 17 were boys and 16 were girls with a mean age of 79.5months. 26 episodes were due to varicella, 21 to herpes zoster and 4 to recurrent varicella. From the children with varicella, 42.3% were in clinical status B or C, 85.7% were in immunological status 2 or 3.80.9% of the patients with herpes zoster and 100% of those with recurrent varicella were in clinical status B or C. 100% of the children with two or more events were in immunological status 2 or 3. 35 of the 51events, were medicated with oral acyclovir, 5 with intravenous acyclovir and 10 did not receive medication. None of the patients showed complications after either oral or intravenous acyclovir or no treatment. Conclusions. 1) The incidence of VZV infection in these population of 60 perinatally HIV infected children was 55%. 2) There was no difference in the clinical presentation and outcome of VZV related to the immunological status but more further events were registered in patients with lower CD4. 3) We did not observe any complications related to VZV infection in patients treated orally, intravenously or non-treated with acyclovir.

Keywords : Perinatally acquired HIV infection; Varicellazoster virus; Varicella; Herpes zoster; Oral acyclovir.

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