HIV and Disability Updating the Social Security Listings (2010) / Chapter Skim
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7 Concepts Specific to Children With HIV/AIDS
7 Concepts Specific to Children With HIV/AIDS
Pages 87-100
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From page 87... ...
As noted below, survival is now markedly improved and many perinatally infected children are aging into adolescence and young adulthood. Understanding of the consequences of early HIV infection in this population is a rapidly evolving field and is the main focus of the majority of current research in pediatric HIV.
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From page 88... ...
Complications include growth abnormalities, developmental and pubertal delay, abnormal metabolic profiles and fat distribution, decreased bone mineral density, and increased mental health disorders. Furthermore, as these perinatally infected children age into adolescence and young adulthood and become
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From page 89... ...
Because early adolescent development is characterized by the rapid physiologic body changes of puberty with a heightened awareness of their body image and concern for physical attraction, perinatally infected children may have altered self-images. Metabolic Metabolic abnormalities in cholesterol, triglycerides, and insulin that may have long-term effects on cardiac health also have been observed in perinatally HIV-infected children.
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From page 90... ...
Neurologic Neurological manifestations of HIV infections are seen more frequently in children than in adults. In the early years of the epidemic, 50 to 90 percent of HIV-infected children showed signs of progressive central nervous system disorders (Lindsey et al., 2007; Singh et al., 2010)
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From page 91... ...
However, isolating the role of HIV infection remains difficult because many of the risk factors associated with mental health disorders overlap with those for HIV (e.g., poverty, disrupted home life, history of mental illness, substance abuse) (Jeremy et al., 2005)
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From page 92... ...
Based on these findings, the committee has recommended a listing based on CD4 count in adults. Similarly, outcome measures such as CD4 count and percentage, viral load, and number of hospitalizations help to characterize morbidity associated with HIV infection in children.
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From page 93... ...
This group also studied the predictive value of CD4 count for disease progression and found that patterns in children ages 4 to 5 or older were similar to that observed in adults (HIV Paediatric Prognostic Markers Collaborative Study, 2006)
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From page 94... ...
. Growth disturbance or failure to grow has been associated with rapid progression from asymptomatic HIV infection to AIDS in children, thus leading to shorter survival (Baylor International Pediatric AIDS Initiative, 2010)
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From page 95... ...
Therefore, the committee recommends that Recommendation 5 should also apply to the Part B HIV Infection Listing. Lymphocytic Interstitial Pneumonia/Pulmonary Lymphoid Hyperplasia Complex The committee decided the lymphoid interstitial pneumonia/pulmonary lymphoid hyperplasia complex (current 114.08J)
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From page 96... ...
. However, studies have since shown that it is not associated with shorter survival in HIV-infected children and that the presence of lymphocytic interstitial pneumonia/pulmonary lymphoid hyperplasia complex is actually seen as having improved the survival rates (de Martino et al., 1991; Lynch et al., 2001)
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From page 97... ...
in Pediatric AIDS Clinical Trials Group 219C. Journal of Acquired Immune Deficiency Syndromes 38(4)
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From page 98... ...
2008. Long-term effectiveness of highly active antiretroviral therapy on the survival of children and adolescents with HIV infection: A 10-year follow-up study.
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From page 99... ...
2004. Natural history of lipid abnormalities and fat redis tribution among human immunodeficiency virus-infected children receiving long-term, protease inhibitor-containing, highly active antiretroviral therapy regimens.
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