RESUMO
Objective: To determine the prevalence of HLA-B*5701 allele in HIV-infected children, andtofind its associationwith Abacavir hypersensitivity. Methods: Children (2 to 18 y) already on,or to be initiated on Abacavir were included for PCR sequencing to detect HLA-B*5701.Outcome measures were: proportion with HLA B*5701 allele and hypersensitivity withAbacavir. Abacavir was stopped if patient tested positive for HLA-B*5701 allele. Results:100 children(median age 11 y) were enrolled; 10 were already on Abacavir. HLA-B*5701positivity was observed in 11 (11%) children. Two of these 11 children developedhypersensitivity after initiation of Abacavir. Abacavir was thereafter stopped in all whotested HLA-B*5701 positive, irrespective of the development of hypersensitivity reaction.Conclusion: HLA-B*5701 allele was present in 11 (11%) of HIV-infected children,of whichtwo developed Abacavir hypersensitivity. None of the patients without the allele developedhypersensitivity.
RESUMO
One of the greatest successes in AIDS research to date has by far been the discovery of successful interventions that interrupt the transmission of HIV from mother to child. It is however important to note that these successes have occurred largely in countries with great resources and the least burden of perinatal transmission of HIV. In the developing world wherein currently 95% of vertical transmission of HIV occurs, it is highly condemnable that still every minute an infected infant is said to be born in spite of the fact that vertical transmission is largely preventable, mainly because translating knowledge into practice is not always possible or feasible; This has led to a continuous growing numbers of children with HIV, thereby making pediatric HIV a looming problem rapidly draining the already burdened health care system of these countries. It is the need of the hour to appropriately address the challenges to achieve zero percent transmission of HIV from an infected mother to her child thereby giving a hope for an AIDS-free new generation worldwide.
RESUMO
With the human immunodeficiency virus (HIV) epidemic showing a shift towards women and young people, the increasing seroprevalence among women will result in an increase in the mother-to-child transmission of HIV. The vast majority of HIV-positive children worldwide acquire the infection through vertical transmission. The discovery of successful interventions that interrupt this transmission has been one of the greatest successes in AIDS research. The transmission of HIV from an infected mother to her child can be reduced to less than 2 peer cent by intensive interventions in the antenatal, intranatal and postnatal periods. To achieve this low rate, primary prevention of HIV infection in parents-to-be, early identification of seropositivity in pregnant women, prevention of unwanted pregnancies, prevention of mother-to-child transmission of HIV by appropriate antiretroviral therapy, special interventions in maternal management during labour, appropriate care and follow up of the newborn, all play an important role. However, these approaches are not always possible in developing countries wherein currently 95 per cent of vertical transmission occurs. Several questions and challenges remain. These include choice, availability, affordability, duration, long-term safety of optimal antiretroviral agents to be used during pregnancy and early neonatal life and the issue of transmission via breastfeeds in situations where alternatives to breastfeeding are not available. The challenge is to find the most cost-effective and feasible intervention to achieve zero per cent transmission of HIV from an infected mother to her child.