Tetanus immunity after diphtheria, tetanus toxoids, and acellular pertussis vaccination in children with clinically stable HIV infection.

Background: HIV infection often impairs the immune response to childhood vaccines.

Objective: We sought to study the ability of HIV-infected children receiving highly active antiretroviral therapy (HAART) to generate a booster response to immunization with a recall antigen to which they had lost humoral immunity.

Methods: Diphtheria, tetanus toxoids, and acellular pertussis (DTaP) vaccination was given at either 16 or 36 weeks after initiation of HAART to 37 HIV-infected children 2 to 9 years of age with a history of DTaP or diphtheria-tetanus-pertussis receipt who had negative tetanus antibody titers ( View Article and Find Full Text PDF

Immunological response to highly active antiretroviral therapy in children with clinically stable HIV-1 infection.

We studied changes in 60 immunological parameters after the administration of highly active antiretroviral therapy (HAART) in 192 clinically stable antiretroviral drug-experienced HIV-1-infected children 4 months-17 years old. The studied immunological parameters included standard lymphocyte subsets and lymphocyte surface markers of maturation and activation. The most significant changes during the 48-week study period were seen for CD8(+), CD8(+)CD62L(+)CD45RA(+), CD8(+)CD38(+)HLA-DR(+), and CD4(+) T cell percentages (P < .

Growth of human immunodeficiency virus-infected children receiving highly active antiretroviral therapy.

Background: Weight and height growth of HIV-infected children tends to lag behind that of uninfected children of similar age. Previous reports of the effect of highly active antiretroviral therapy (HAART) on the growth of HIV-infected children have been contradictory.

Methods: Age- and gender-adjusted height and weight z scores were studied for 192 HIV-infected children, 4 months to 17 years of age, who had been treated with antiretroviral therapy for at least 16 weeks.

Levofloxacin secretion in breast milk: a case report.

Objective: To evaluate levofloxacin secretion in human breast milk.

Methods: Breast milk was collected from a lactating woman during a 23-day period in which she received levofloxacin 500 mg/day and for 5 days after discontinuation of levofloxacin. The levofloxacin concentration was assayed by high-performance liquid chromatography.

Neuropsychological functioning and viral load in stable antiretroviral therapy-experienced HIV-infected children.

Objective: Neuropsychological functioning and its correlation with viral load were investigated for previously treated HIV-infected children who underwent a change in treatment regimen.

Methods: Thirteen age-appropriate measures of cognitive, neurologic, and behavioral functioning were administered to 489 HIV-infected children who were aged 4 months to 17 years and had been treated previously for at least 16 weeks with antiretroviral therapy. These clinically and immunologically stable children were randomized onto 1 of 7 drug treatment combinations, 6 of which included a protease inhibitor (PI), and evaluated prospectively for 48 weeks with respect to changes in neuropsychological performance and viral load.

Reported adherence as a determinant of response to highly active antiretroviral therapy in children who have human immunodeficiency virus infection.

Objective: The complexity of highly active antiretroviral therapy (HAART), with multiple medications, formulations, and dosing intervals, makes adherence challenging. Little is known about the adherence of children to HAART. The objective of this study was to identify correlates of adherence to HAART and the relationship between adherence and study outcomes in a pediatric clinical trial.

Vaccination update.

Preview Inadequate immunization of infants, children, and persons at high risk for certain infectious diseases continues to result in excess deaths every year in the United States. With improved vaccination rates, many of these deaths could be prevented. This article focuses on current immunization guidelines and recent developments in the battle against seven vaccine-preventable diseases.

Vaccination update.

Preview Although the incidence of many vaccine-preventable diseases has fallen dramatically, routine vaccination should be a goal of all primary care physicians. Childhood immunization programs alone will not eliminate these diseases, which are still responsible for substantial illness and death in infants, young adults, and the elderly. In this article, Drs Vetter and Johnson discuss recent developments in immunization against six common infectious diseases.