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Multiple viral infections in HIV-infected children with chronically-evolving hepatitis

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Research in Chronic Viral Hepatitis

Summary

Hepatic involvement was investigated in 31 children with perinatal HIV-1 infection, who were followed for 2–82 months (mean 30.5). Liver disease, as revealed by increased aminotransferase levels, liver biopsy or necroscopy, was diagnosed in 18 children (58%), of which 7 (22.5%) had acute hepatitis and 11 (35.5%) showed chronic liver disease. Overall, 40 persistently active or recurrent viral infections, as demonstrated by positive culture and/or detection of serum DNA, specific IgM, IgA and high levels of IgG, were revealed in the children with liver disease, while 12 similar infections were detected in 13 children without liver disease (p < 0.001). In particular, the children with liver disease showed a significantly (p < 0.002) higher incidence of cytomegalovirus (CMV) infections than children without liver disease (13 versus 3). Moreover, hepatitis C and B virus infections were revealed only in children with liver disease (5 and 1 patients, respectively). Clinical outcome showed a significantly (p < 0.001) higher mean survival in the children without liver disease than those with liver disease (47.5 versus 18.2 months). In fact, nine of the children with liver disease (50%) died, as opposed to only one of the children without liver disease (7.7%; p = 0.01). Based on these findings, liver disease is indicative of a poor prognosis in children with HIV infection, being related to the presence of multiple active viral infections.

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References

  1. Anderson MJ (1991) Parvoviruses. In: Belshe RB (ed) Textbook of human virology. Mosby Year Book, St Louis, pp 1012–1020

    Google Scholar 

  2. Banks TA, Rouse BT (1992) Herpesviruses - immune escape artists? Clin Infect Dis 14: 933–941

    Article  PubMed  CAS  Google Scholar 

  3. Bronsther O, Makowka L, Jaffe R, Demetris AJ, Breinig MK, Ho M, Esquivel CO, Gordon RD, Iwatsuki S, Tzakis A, Marsh JW Jr, Mazzaferro V, Van Thiel D, Starzl TE (1988) Occurrence of cytomegalovirus hepatitis in liver transplant patients. J Med Virol 24: 423–434

    Article  PubMed  CAS  Google Scholar 

  4. Brytting M, Sundqvist V-A, Stalhandske P, Linde A, Wahren B (1991) Cytomegalovirus DNA detection of an immediate early protein gene with nested primer oligonucleotides. J Virol Methods 32: 127–138

    Article  PubMed  CAS  Google Scholar 

  5. Centers for Disease Control (1987) Classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age. MMWR 36: 225–236

    Google Scholar 

  6. Falloon J, Eddy J, Wiener L, Pizzo PA (1989) Human immunodeficiency virus infection in children. J Pediatr 114: 1–30

    Article  PubMed  CAS  Google Scholar 

  7. Frenkel LD, Gaur S, Tsolia M, Scudder R, Howell R, Kesarwala H (1990) Cytomegalovirus infection in children with AIDS. Rev Infect Dis 12: S820–S826

    Article  PubMed  Google Scholar 

  8. Fridell E, Cohen BJ, Wahren B (1991) Evaluation of a synthetic peptide enzyme- linked immunosorbent assay for immunoglobulin M to human parvovirus B19. J Clin Microbiol 29: 1376–1381

    PubMed  CAS  Google Scholar 

  9. Fridell E, Bekassy AN, Larsson B, Eriksson BM (1992) Polymerase chain reaction with double primer pairs for detection of human parvovirus B19 induced aplastic crises in family outbreaks. Scand J Infect Dis 24: 275–282

    Article  PubMed  CAS  Google Scholar 

  10. Garbuglia AR, Manzin A, Budkowska A, Taliani G, Clementi M, Delfini C, Carloni C (1991) Levels of pre-S antigens and HBV DNA in sera from high and low viremic HBV carriers. J Med Virol 35: 273–282

    Article  PubMed  CAS  Google Scholar 

  11. Linde A, Dahl H, Wahren B, Fridell E, Salahuddin Z, Biberfeld P (1988) IgG antibodies to human herpesvirus-6 in children and adults both in primary Epstein- Barr virus and cytomegalovirus infections. J Virol Methods 21: 117–123

    Article  PubMed  CAS  Google Scholar 

  12. Nigro G, Mattia S, Midulla M (1989) Simultaneous detection of specific serum IgM and IgA antibodies for rapid serodiagnosis of congenital or acquired cytomegalovirus infection. Serodiagn Immunother Infect Dis 3: 808–813

    Article  Google Scholar 

  13. Nigro G, Bartmann U, Mattia S, Nastasi V, Torre V, Manganaro M, Perrone T, Tucciarone L (1992) Acute hepatitis in childhood: virological, immunological and clinical aspects. Biomed Pharmacother 46: 155–160

    Article  PubMed  CAS  Google Scholar 

  14. Nigro G, Luzi G, Fridell E, Ferrara M, Pisano P, Castelli Gattinara G, Mezzaroma I, Söderlund M, Rasnoveanu D, Aiuti F (1992) Parvovirus infection in children with AIDS: high prevalence of B19-specific immunoglobulin M and G antibodies. AIDS 6: 679–684

    Article  PubMed  CAS  Google Scholar 

  15. Nigro G, Mattia S, Vitolo R, Bartmann U, Midulla M (1992) Hepatitis in preschool children: prevalent role of cytomegalovirus. Arch Virol [Suppl] 4: 268–272

    CAS  Google Scholar 

  16. Oleske J, Minnefor A, Cooper R, Thomas K, dela Cruz A, Ahdieh H, Guerrero I, Joshi VV, Desposito F (1983) Immune deficiency syndrome in children. JAMA 249: 2345–2349

    Article  PubMed  CAS  Google Scholar 

  17. Oxtoby MJ (1990) Perinatally acquired human immunodeficiency virus infection. Pediatr Infect Dis J 9: 609–619

    PubMed  CAS  Google Scholar 

  18. Prufer-Kramer L, Kramer A, Weigel R, Rogler G, Fleige B, Krause PH, Hahn EG, Riecken EO, Pohle HD (1991) Hepatic involvement in patients with human immunodeficiency virus infection: discrepancies between AIDS patients and those with earlier stages of infection. J Infect Dis 163: 866–869

    Article  PubMed  CAS  Google Scholar 

  19. Rando RF, Pellett PE, Luciw PA, Bohan CA, Srinivasan A (1987) Transactivation of human immunodeficiency virus by herpesviruses. Oncogene 1: 13–18.

    PubMed  CAS  Google Scholar 

  20. Rustgi VK, Hoofnagle JH, Gerin JL, Gelmann EP, Reichert CM, Cooper JN, Macher AM (1984) Hepatitis B virus infection in the acquired immunodeficiency syndrome. Ann Intern Med 101: 795–797

    PubMed  CAS  Google Scholar 

  21. Sacks SL, Freeman HJ (1984) Cytomegalovirus hepatitis: evidence for direct hepatic viral infection using monoclonal antibodies. Gastroenterology 86: 346 - 354

    PubMed  CAS  Google Scholar 

  22. Scott GB, Buck BE, Leterman JG, Bloom FL, Parks WP (1984) Acquired immunodeficiency syndrome in infants. N Engl J Med 310: 76–81

    Article  PubMed  CAS  Google Scholar 

  23. Snover DC, Horwitz CA (1984) Liver disease in cytomegalovirus mononucleosis: a light microscopical and immunoperoxidase study of six cases. Hepatology 4: 408–415

    Article  PubMed  CAS  Google Scholar 

  24. Söderlund M, Brown KE, Meurman O, Hedman K (1992) Prokaryotic expression of a VP1 polypeptide antigen for diagnosis by a human parvovirus B19 antibody enzyme immunoassay. J Clin Microbiol 30: 305–311

    PubMed  Google Scholar 

  25. Taliani G, Badolato MC, Lecce R, Bruni R, Clementi C, Grimaldi F, Furlan C, Manganaro M, Duca F, Bozza A, Poliandri G, De Bac C Isolate antibody to hepatitis C core antigen (C22): correlation with HCV-RNA and anti-NS5. Arch Virol [Suppl] 8: 219–228

    Google Scholar 

  26. Tovo PA, De Martino M, Gabiano C, Cappello N, D’Elia R, Loy A, Plebani A, Zuccotti GV, Dallacasa P, Ferraris G, Caselli D, Fundaro C, D’Argenio P, Galli L, Principi N, Stegagno M, Ruga E, Palomba E and the Italian Register for HIV infection in children (1992) Prognostic factors and survival in children with perinatal HIV-1 infection. Lancet 339: 1249–1253

    Article  PubMed  CAS  Google Scholar 

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© 1993 Springer-Verlag

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Nigro, G. et al. (1993). Multiple viral infections in HIV-infected children with chronically-evolving hepatitis. In: Gerlich, W.H. (eds) Research in Chronic Viral Hepatitis. Archives of Virology Supplementum, vol 8. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9312-9_24

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  • DOI: https://doi.org/10.1007/978-3-7091-9312-9_24

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-82497-9

  • Online ISBN: 978-3-7091-9312-9

  • eBook Packages: Springer Book Archive

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