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Journal of Tropical Pediatrics Advance Access published online on July 14, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp057
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Severe Infections in HIV-Exposed Uninfected Infants: Clinical Evidence of Immunodeficiency

A. L. Slogrovea, M. F. Cottona,b and M. M. Essera,c

aTygerberg Children's Hospital and Stellenbosch University, Department of Paediatrics and Child Health
bChildren's Infectious Diseases Clinical Research Unit (KID-CRU)
cNational Health Laboratory Services (NHLS)

Correspondence: Dr Amy Slogrove, Tygerberg Children's Hospital, Francie Van Zijl Ave, Tygerberg, 7505 Western Cape, South Africa. Tel.: +27-21-938-4538; Fax: +27-21-938-4858. E-mail: <amy{at}sun.ac.za>.


  Abstract

We describe the clinical and basic immunological findings of eight HIV-exposed uninfected infants hospitalized with serious infectious morbidity and referred for immunological evaluation. The median age at presentation was 5.5 (1.5–15) months. Infections included Pneumocystis jiroveci pneumonia (three), cytomegalovirus colitis with perforation (one), Pseudomonas sepsis (two), hemorrhagic varicella (one) and Group A streptococcal meningitis and endocarditis (one). Five required intensive care, four for assisted ventilation and one for post-surgical care. Follow-up to 36 months suggested resolution of a transient immunodeficiency in two infants, one of whom had CD4 and the other B-cell depletion. Further studies are indicated in HIV-exposed uninfected infants.

Key Words: HIV-exposed uninfected • infectious morbidity • immuneparesis • Pneumocystis jiroveci


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