Older children and adolescents surviving with vertically acquired HIV infection.

This article describes the characteristics of children infected vertically with HIV surviving 10 years or more who were enrolled in the prospective European Collaborative Study. 34 of 187 infected children were identified with a median age of 11.4 years (range 10.1-15.9 years). Factors examined included clinical status immunologic and virologic characteristics type of antiretroviral therapy and psychosocial characteristics. By 10 years of age 6 (18%) children had progressed to Class A as determined by the system of the US Centers for Disease Control and Prevention 17 (52%) to class B 7 (21%) to class C and 3 (9%) had remained asymptomatic. At 73% (904 of 1234) of scheduled clinic visits these children had no symptoms of HIV disease. Most children were in Centers for Disease Control immune categories 1 (18 56%) or 2 (11 34%) at their last visit. Three-quarters (24 patients) were on combination therapy with three of more drugs although 3 children had never received any antiretroviral therapy. 19 (56%) children were living with at least 1 parent and the mothers of 13 (38%) children had died. Most (77%) children had been told about their HIV infection. Children infected vertically with HIV who have survived their first 10 years are mainly free of serious symptoms. As they enter adolescence additional services are needed including support with disclosure to others therapy and sexual health. (authors)