SS Chiu, YL Lau

Abstract

To date, 17 children with perinatally-acquired human immunodeficiency virus (HIV) infection have been diagnosed and reported in Hong Kong. We reported on our experience at Queen Mary Hospital with 8 of the 11 children diagnosed in 2000. Since then, 4 more children have been referred to us. This study reports on these new patients as well as provides an update on the existing patients from May 2000 to May 2006. Two of the four new patients had AIDS at the time of diagnosis. All patients were given highly active antiretroviral therapy. Over 80% of the infected children had long-term undetectable HIV viral load after initiation of treatment, the longest duration being 7 years to date. Changes in management as a result of immune reconstitution in these children included the discontinuation of monthly IVIG infusion in some children and the discontinuation of primary prophylaxis against Pneumocystis jirovecii pneumonia, formerly Pneumocystis carinii pneumonia (PCP). Disclosure was an important issue as the children were growing older. With the exception of one 4 years old boy who was too young, full disclosure was achieved in half of the patients with a mean age of 8.9 years. As these medically well children enter adolescence, additional services including support with disclosure to others, self acceptance, therapy and sexual health would be needed.