Children infected with HIV at birth are surviving into adolescence, overturning the assumption that virtually all die before the age of five, doctors working in Zimbabwe will reveal this week.
But because the children's growth has been stunted, they will face particular difficulties as they enter puberty.
Doctors working in sub-Saharan Africa have been noticing older children arriving at HIV clinics with the late stage of the disease. But until now, there has been no proof that this reflected more than the survival from birth of a few individuals.
Researchers from the Wellcome Trust studied older children arriving at a clinic in Harare, Zimbabwe, and have demonstrated that the numbers are significant.
Half a million babies are estimated to have been infected with HIV at birth or during breastfeeding last year alone. The Zimbabwe study suggested that as many as one in four may survive into adolescence.
"The findings are quite extraordinary," said Liz Corbett, a Wellcome Trust senior clinical fellow in tropical medicine from the London School of Hygiene and Tropical Medicine in Zimbabwe.
"The phenomenon of long-term survival is poorly recognized and until recently has been almost positively resisted by the international HIV community because of the strongly held assumptions that HIV in late childhood is very unusual and that survival from birth to adolescence with HIV was so unlikely without treatment as to be negligible. This just doesn't fit with what we see in Zimbabwe and hear from neighboring countries," she said.
"It is now being realized that these earlier assumptions were wrong and that instead somewhere around one in 10 infected infants -- and perhaps even as high as one in four -- may survive into late childhood or early adolescence without diagnosis or treatment," she said.
The study was carried out by researchers at the Connaught clinic for children in Harare and is to be published this week in the journal Clinical Infectious Diseases.
They assessed 32 children between eight and 19 years of age who had arrived at the clinic with advanced HIV infection and in urgent need of antiretroviral drugs. The median age of their first HIV test was 11 and most had at that point experienced HIV-related symptoms more than three years earlier.
Rashida Ferrand, lead author of the paper, said it was not possible to be 100 percent sure that the children were infected at birth, but it was likely because they were AIDS orphans or their parents had AIDS and they had siblings who had died of AIDS.
"One of the really surprising things is they are surviving without treatment, while being exposed to other infections," she said.
There have also been observations of older children with late-stage HIV infection in other countries with long-established epidemics and some UK children from sub-Saharan Africa.
"The accepted view was that the majority would die before the age of five," Ferrand said. "Studies did not follow the kids up. They are surviving but they are not surviving asymptomatically. They get AIDS or they are living with recurrent infections which has hugely serious implications."
Two medieval fortresses face each other across the Narva River separating Estonia from Russia on Europe’s eastern edge. Once a symbol of cooperation, the “Friendship Bridge” connecting the two snow-covered banks has been reinforced with rows of razor wire and “dragon’s teeth” anti-tank obstacles on the Estonian side. “The name is kind of ironic,” regional border chief Eerik Purgel said. Some fear the border town of more than 50,0000 people — a mixture of Estonians, Russians and people left stateless after the fall of the Soviet Union — could be Russian President Vladimir Putin’s next target. On the Estonian side of the bridge,
Civil society leaders and members of a left-wing coalition yesterday filed impeachment complaints against Philippine Vice President Sara Duterte, restarting a process sidelined by the Supreme Court last year. Both cases accuse Duterte of misusing public funds during her term as education secretary, while one revives allegations that she threatened to assassinate former ally Philippine President Ferdinand Marcos Jr. The filings come on the same day that a committee in the House of Representatives was to begin hearings into impeachment complaints against Marcos, accused of corruption tied to a spiraling scandal over bogus flood control projects. Under the constitution, an impeachment by the
Jeremiah Kithinji had never touched a computer before he finished high school. A decade later, he is teaching robotics, and even took a team of rural Kenyans to the World Robotics Olympiad in Singapore. In a classroom in Laikipia County — a sparsely populated grasslands region of northern Kenya known for its rhinos and cheetahs — pupils are busy snapping together wheels, motors and sensors to assemble a robot. Guiding them is Kithinji, 27, who runs a string of robotics clubs in the area that have taken some of his pupils far beyond the rural landscapes outside. In November, he took a team
Exiled Tibetans began a unique global election yesterday for a government representing a homeland many have never seen, as part of a democratic exercise voters say carries great weight. From red-robed Buddhist monks in the snowy Himalayas, to political exiles in megacities across South Asia, to refugees in Australia, Europe and North America, voting takes place in 27 countries — but not China. “Elections ... show that the struggle for Tibet’s freedom and independence continues from generation to generation,” said candidate Gyaltsen Chokye, 33, who is based in the Indian hill-town of Dharamsala, headquarters of the government-in-exile, the Central Tibetan Administration (CTA). It
RSS