PEDIATRICS Vol. 90 No. 5 November 1992, pp. 688-691
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Delayed Recognition of Human Immunodeficiency Virus Infection in Preadolescent Children

Deborah Persaud MD1, Sulachni Chandwani MD1, Mona Rigaud MD1, Eugene Leibovitz MD1, Aditya Kaul MD1, Robert Lawrence MD1, Henry Pollack MD1, David DiJohn MD1, Keith Krasinski MD1, and William Borkowsky MD1

1 From the Department of Pediatrics, Division of Infectious Diseases and Immunology, New York University Medical Center/Bellevue Hospital Center, New York, NY.

Thirty-two (18%) of 181 children cared for at our institution who were infected with the human immunodeficiency virus type 1 (HIV-1) were first seen, and HIV was diagnosed, when they were 4 years of age and older. Initial complaints or diagnoses for these children included the following: hematologic disorders (5) (3 idiopathic thrombocytopenic purpura, 1 neutropenia, 1 anemia); recurrent bacterial infections (10); Pneumocystis carinii pneumonia (3); developmental delay (1); skin disorders (2) (1 genital wart, 1 chronic zoster); weight loss (3); malignancy (1); and nephropathy (1). Eight children were referred for evaluation because of maternal HIV-1 infection. The risk factors for HIV-1 infection included maternal/perinatal exposure (22), perinatal blood transfusion (6), blood transfusion during infancy (2), and sexual abuse (2). Ten (31%) of the 32 children have subsequently died. The longest survival from perinatal infection was 12 years. HIV-1 infection in children can result in a prolonged clinical latency and can masquerade as other pathologic conditions. The absence of clinical symptoms in older children at risk for HIV-1 infection should not deter HIV testing.

Key Words: human immunodeficiency virus • acquired immunodeficiency syndrome • preadolescents

Submitted on January 17, 1992
Accepted on April 15, 1992




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