Información del artículo
Resumen
Desde que se conoció la infección por el virus de la inmunodeficiencia humana (VIH), se han diagnosticado más de 2,5 millones de niños infectados a nivel mundial. Con este conocimiento vino también la generación del tratamiento HAART (Highly Active Antiretroviral Therapy), que logró mejorar la calidad de vida y la expectativa de vida de los lactantes infectados. Sin embargo, los individuos que reciben tratamiento presentan condiciones particulares que los hacen constituir un grupo de individuos con necesidades de atención y cuidado diferentes. En esta revisión se abordan los aspectos clínicos más relevantes que aquejan a los niños infectados por VIH que reciben tratamiento antirretroviral altamente activo.
Palabras clave:
infantes
VIH
HAART
Abstract
Since the human immunodeficiency virus (HIV) was known, more than 2.5 million infected children around the world have been diagnosed. With this knowledge also came the advent of the Highly Active Antiretroviral Therapy (HAART) which has achieved a better quality of life and greater life expectancy of unweaned infected babies. However, people receiving this therapy present particular conditions that make them a population with different attention and care needs. This review addresses the most relevant clinical aspects present in HIV infected children receiving HAART.
Key words:
child
HIV
HAART
El Texto completo está disponible en PDF
Referencias
[1.]
UNAIDS. UNAIDS Report on the global AIDS epidemic. 2010. Fecha de consulta: 1° de noviembre de 2011. Disponible en:http://www.unaids.org/globalreport/Epi_slides.htm.
[2.]
M. Lallemant, S. Chang, R. Cohen, B. Pecoul.
Pediatric HIV - A neglected disease?.
N Engl J Med, 365 (2011), pp. 381-383
[3.]
Programa de las Naciones Unidas para el desarrollo - Colombia. Combatir el VIH/SIDA, la malaria y el dengue. Fecha de consulta: 3 de noviembre de 2011. Disponible en:http://www.pnud.org.co/img_upload/33323133323161646164616461646164/Combatir%20el%20VIH%20SIDA,%20la%20Malaria%20y%20el%20Dengue.pdf
[4.]
Caracol Radio. Nota periodística: Colombia tiene más de 2 mil niños con VIH Sida. Fecha de consulta: 1° de noviembre de 2011. Disponible en:www.caracol.com.co/nota.aspx?id=834310
[5.]
V. Vivet-Boudou, J. Didierjean, C. Isel, R. Marquet.
Nucleoside and nucleotide inhibitors of HIV-1 replication.
Cell Mol Life Sci, 63 (2006), pp. 163-186
[6.]
A. Blas-García, J.V. Esplugues, N. Apostolova.
Twenty years of HIV-1 non-nucleoside reverse transcriptase inhibitors: Time to reevaluate their toxicity.
Curr Med Chem, 18 (2011), pp. 2186-2195
[7.]
I. Pérez-Valero, J.R. Arribas.
Protease inhibitor monotherapy.
Curr Opin Infect Dis, 24 (2011), pp. 7-11
[8.]
D.R. Kuritzkes.
HIV-1 entry inhibitors: An overview.
Curr Opin HIV AIDS, 4 (2009), pp. 82-87
[9.]
W.G. Powderly.
Integrase inhibitors in the treatment of HIV-1 infection.
J Antimicrob Chemother, 65 (2010), pp. 2485-2488
[10.]
H. Gautam, P. Bhalla, S. Saini, R. Dewan.
Correlation between baseline CD4 + T-lymphocyte count and plasma viral load in AIDS patients and their early clinical and immunological response to HAART: A preliminary study.
Indian J Med Microbiol, 26 (2008), pp. 256-258
[11.]
L. Cardoso, P.H. de Carvalho, H.H. de Sousa, S.B. de Andrade.
Dyslipidaemia and insulin resistance in vertically HIV-infected children and adolescents.
Trans R Soc Trop Med Hyg, 105 (2011), pp. 197-203
[12.]
E. Sprinz, R. Kuhmmer, R. Kuhmmer, J. Pinto.
Dyslipidemia in HIV-infected individuals.
Braz J Infect Dis, 14 (2010), pp. 575-588
[13.]
P. López, Y. Caicedo, L.C. Rubiano, C.A. Cortés, A. Valencia, O. Ramírez, et al.
Alteraciones metabólicas con terapia antirretroviral altamente efectiva en niños positivos para VIH, Cali, Colombia.
Infectio, 13 (2009), pp. 283-292
[14.]
E.R. Feeney, P.W.G. Mallo.
Insulin resistance in treated HIV infection.
Best Pract Res Clin Endocrinol Metab, 25 (2011), pp. 443-458
[15.]
T.T. Brown, X. Li, S.R. Cole, L.A. Kingsley, F.J. Palella, S.A. Riddler, et al.
Cumulative exposure to nucleoside analogue reverse transcriptase inhibitors is associated with insulin resistance markers in the multicenter AIDS cohort study.
AIDS, 19 (2005), pp. 1375-1383
[16.]
M. Guzmán-Fulgencio, D. Micheloud, R. Lorente, J.M. Bellón, M.I. Gómez, M.D. Gurbindo, et al.
Cardiovascular risk markers are increased in HIV-infected children with lipodystrophy syndrome.
J Infect, 62 (2011), pp. 240-243
[17.]
M. Beregszaszi, C. Dollfus, M. Levine, A. Faye, S. Deghmoun, N. Bellal, et al.
Longitudinal evaluation and risk factors of lipodystrophy and associated metabolic changes in HIV-infected children.
J Acquir Immune Defic Syndr, 40 (2005), pp. 161-168
[18.]
P. Fiore, E. Donelli, S. Boni, E. Pontali, R. Tramalloni, D. Bassetti.
Nutritional status changes in HIV-infected children receiving combined antiretroviral therapy including protease inhibitors.
Int J Antimicrob Agents, 16 (2000), pp. 365-369
[19.]
A. Viganò, G.V. Zuccotti, C. Cerini, S. Stucchi, M. Puzzovio, V. Giacomet, et al.
Lipodystrophy insulin resistance, and adiponectin concentration in hiv-infected children and adolescents.
Curr HIV Res, 9 (2011), pp. 321-326
[20.]
C. Lagathu, M. Kim, M. Maachi, C. Vigouroux, P. Cervera, J. Capeau, et al.
HIV antiretroviral treatment alters adipokine expression and insulin sensitivity of adipose tissue in vitro and in vivo.
Biochimie, 87 (2005), pp. 65-71
[21.]
M. Gerschenson, K. Brinkman.
Mitochondrial dysfunction in AIDS and its treatment.
Mitochondrion, 4 (2004), pp. 763-777
[22.]
S.B. Foster, K. McIntosh, B. Thompson, M. Lu, W. Yin, K.C. Rich, et al.
Increased incidence of asthma in HIV-infected children treated with highly active antiretroviral therapy in the National Institutes of Health Women and Infants Transmission Study.
J Allergy Clin Immunol, 122 (2008), pp. 159-165
[23.]
G.K. Siberry, E. Leister, D.L. Jacobson, S.B. Foster, G.R. Seage III, S.T. Lipshultz, et al.
Increased risk of asthma and atopic dermatitis in perinatally HIV-infected children and adolescents.
Clin Immunol, 142 (2012), pp. 201-208
[24.]
F. Fernández.
Neuropsychiatric aspects of human immunodeficiency virus (HIV) infection.
Curr Psychiatry Rep, 4 (2002), pp. 228-231
[25.]
C. Raines, O. Radcliffe, G.J. Treisman.
Neurologic and psychiatric complications of antiretroviral agents.
J Assoc Nurses AIDS Care, 16 (2005), pp. 35-48
[26.]
J.K. Neuenburg, H.R. Brodt, B.G. Herndier, M. Bickel, P. Bacchetti, R.W. Price, et al.
HIV-related neuropathology, 1985 to 1999: Rising prevalence of HIV encephalopathy in the era of highly active antiretroviral therapy.
J Acquir Immune Defic Syndr, 31 (2002), pp. 171-177
[27.]
R.J. Jeremy, S. Kim, M. Nozyce, S. Nachman, K. McIntosh, S.I. Pelton, et al.
Neuropsychological functioning and viral load in stable antiretroviral therapy-experienced HIV-infected children.
Pediatrics, 115 (2005), pp. 380-387
[28.]
P. Castro, M.Y. Martínez, I. González, J. Velásquez, G. Castillo, L. Sánchez.
Evaluación neuropsicológica, factores psicosociales y co-morbilidad psiquiátrica en pacientes pediátricos infectados con el VIH.
Rev Chil Infect, 28 (2011), pp. 248-254
[29.]
K. Kieburtz, A.E. Zettelmaier, L. Ketonen, M. Tuite, E.D. Caine.
Manic syndrome in AIDS.
Am J Psychiatry, 148 (1991), pp. 1068-1070
[30.]
D. Williams, A. Geraci, D.M. Simpson.
AIDS and AIDS-treatment neuropathies.
Curr Pain Headache Rep, 6 (2002), pp. 125-130
[31.]
O.L. López, J.T. Becker, M.A. Dew, R. Caldararo.
Risk modifiers for peripheral sensory neuropathy in HIV infection/AIDS.
Eur J Neurol, 11 (2004), pp. 97-102
[32.]
G. Dragovic, D. Jevtovic.
Nucleoside reverse transcriptase inhibitor usage and the incidence of peripheral neuropathy in HIV/AIDS patients.
Antivir Chem Chemother, 14 (2003), pp. 281-284
[33.]
D.D. Richman, M.A. Fischl, M.H. Grieco, M.S. Gottlieb, P.A. Volderbing, O.L. Laskin, et al.
The toxicity of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind placebo-controlled trial.
N Engl J Med, 317 (1987), pp. 192-197
[34.]
G. Arendt, H.J. von Giesen.
Antiretroviral therapy regimens for neuro- AIDS.
Curr Drugs Targets-Infect Disorders, 2 (2002), pp. 187-192
[35.]
T. Hawkins, C. Geist, B. Young, A. Giblin, R.C. Mercier, K. Thornton, et al.
Comparison of neuropsychiatric side effects in an observational cohort of Efavirenz and protease inhibitor-treated patients.
HIV Clin. Trials, 6 (2005), pp. 187-196
[36.]
T. Puzantian.
Central nervous system adverse effects with efavirenz: Case report and review.
Pharmacotherapy, 22 (2002), pp. 930-933
[37.]
L. Gallego, P. Barreiro, R. del Rio, D. González, A. Rodríguez, et al.
Analyzing sleep abnormalities in HIV-infected patients treated with efavirenz.
Clin Inf Dis, 38 (2004), pp. 430-432
[38.]
C.R. Fumaz, A. Tuldrá, M.J. Ferrer, R. Paredes, A. Bonjoch, T. Jou, et al.
Quality of life, emotional status and adherence of HIV-1-infected patients treated with efavirenz versus protease inhibitor-containing regimens.
JAIDS, 29 (2002), pp. 244-253
[39.]
J.L. Guest, K.E. DeSilva, T.D. Flaherty, D.B. Le Flore, D. Rimland.
Incidence of CNS effects in patients with a history of mental health disorders and/or substance abuse starting an efavirenz-containing regimen: Data from HA-VACS.
Abstracts, XIV International AIDS Conference,
[40.]
P. Bonfanti, L. Valsecchi, F. Parazzini, S. Carradori, L. Pusterla, P. Fortuna, et al.
Incidence of adverse reactions in HIV patients treated with protease inhibitors: A cohort study Coordinamento Italiano Studio Allergia e Infezione da HIV (CISAI) Group.
JAIDS, 23 (2000), pp. 236-245
[41.]
G. Gatti, A. Di Biagio, R. Casazza, C. De Pascalis, M. Bassetti, M. Cruciani, et al.
The relationship between ritonavir plasma levels and side-effects: Implications for therapeutic drug monitoring.
AIDS, 13 (1999), pp. 2083-2089
[42.]
M.R. Boulassel, R. Morales, T. Murphy, R.G. Lalonde, M.B. Klein.
Gender and long-term metabolic toxicities from antiretroviral therapy in HIV- 1–infected persons.
J Med Virol, 78 (2006), pp. 1158-1163
[43.]
M.G. Bolhaar, A.S. Karstaedt.
CID, (2007), pp. 255-260
[44.]
A. Noguera, C. Fortuny, E. Sánchez, R. Artuch, M.A. Vilaseca, C. Muñoz- Almagro, et al.
Hyperlactatemia in human immunodeficiency virus-infected children receiving antiretroviral treatment.
Pediatr Infect Dis J, 22 (2003), pp. 778-782
[45.]
A. Alimenti, D.R. Burdge, G.S. Ogilvie, D.M. Money, J.C. Forbes.
Lactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy.
Pediatr Infect Dis J, 22 (2003), pp. 782-789
[46.]
J. Alarcon, L. Freimanis-Hance, M. Krauss, M. Reyes, C. Cardoso, M. Mussi- Pinhata, et al.
Opportunistic and other infections in HIV-infected children in Latin America compared to a similar cohort in the United States.
AIDS Res Hum Retroviruses, 28 (2012), pp. 282-288
[47.]
P. Gona, R.B. van Dyke, P.L. Williams, W.M. Dankner, M.C. Chernoff, S.A. Nachman, et al.
Incidence of opportunistic and other infections in HIV-infected children in the HAART era.
JAMA, 296 (2006), pp. 292-300
[48.]
A.N. Ramos Jr., L.H. Matida, N. Hearst, J. Heukelbach.
Opportunistic illnesses in Brazilian children with AIDS: Results from two national cohort studies, 1983-2007.
AIDS Res Ther, 18 (2011), pp. 8-23
Copyright © 2012. Asociación Colombiana de Infectología (ACIN)
