Pneumocystis carinii pneumonia in infants infected with the human immunodeficiency virus with more than 450 CD4 lymphocytes per cubic millimeter

Article Abstract:

Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to a form of pneumonia caused by infection with the organism Pneumocystis carinii. This pneumonia is often the first symptom of AIDS, and occurs in approximately 70 percent of all children who are infected with the human immunodeficiency virus (HIV). The level of CD4-lymphocytes, a particular type of white blood cell, has been found in adults to be a meaningful measurement of the progression of AIDS. The CD4-lymphocyte level is useful for assessing risk of Pneumocystis carinii pneumonia and for determining the proper time to begin certain drug therapies. A count below 250 CD4-lymphocytes per cubic millimeter has been found to be associated with an increased risk of P. carinii pneumonia in adults, but there has been insufficient data collected regarding the prognostic value of the level of CD4-lymphocytes in children. A group of 22 HIV-infected children with P. carinii pneumonia was evaluated, and levels of CD4-lymphocytes were determined. Of this group, eight children (36 percent) had levels of CD4-lymphocytes in excess of 450 cells/cubic millimeter. The remaining 14 patients had counts below 250 cells/cubic millimeter. This experience with HIV-infected children indicates that CD4-lymphocyte counts which in adults are associated with a reduced risk of P. carinii infection do not indicate reduced susceptibility in children, since all of the 22 children had P. carinii pneumonia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Risk factors, Prognosis, Demographic aspects, Pneumocystis carinii pneumonia, Lymphocytes

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Measles and measles immunity in children infected with human immunodeficiency virus

Article Abstract:

The risks of developing AIDS and the benefits of a measles vaccination need to be weighed before recommendations for the development of a measles vaccination for immunodeficient children infected with human immunodeficiency virus (HIV) are determined. Measles in four children lacking an immune response resulted in three severe pneumonias and one death despite the fact that two of the children had been immunized against measles. The presence of antibody to measles was measured in three of 24 children studied and developed in only two of eight children immunized and followed up. Antibodies were found in blood tests of nine of 24 children. Two of six children whose tests did not show antibodies got the measles. Children infected with HIV showed a low ability to provoke an immune response (immunogenicity) from the measles vaccination. However, the apparent safety helps to justify immunization in the face of a potentially fatal disease. All children infected with HIV should receive preventive treatment such as passive postexposure immunoglobulin prophylaxis, since neither documented immunization nor low-level antibody guaranteed immunity to measles.

Complications and side effects, Children, Immunization of children, Immunization

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The effect of epidemic measles on immunization rates

Article Abstract:

An epidemic of an infectious disease may increase immunization rates for that disease but not necessarily for other communicable diseases. This was discovered during the measles epidemic in Chicago in 1989 and 1990. Measles vaccination rates in children starting school increased from 56% to 58% before the outbreak to 70% during the epidemic. Vaccination rates also increased in older children who wanted to complete the measles vaccination schedule. However, vaccination rates for polio and diphtheria/tetanus/pertussis (DPT) did not change.

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