AEGiS-14IAC: Survival of perinatally HIV-infected children in Canada.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Survival of perinatally HIV-infected children in Canada.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1447)

King SM, Forbes J, Singer J, Lapointe N, Samson L, Embree J, Vaudry W
Hospital for Sick Children and University of Toronto, Toronto, Canada

OBJECTIVES: To determine the cumulative survival and factors affecting survival among perinatally HIV-infected children in Canada.

METHODS: The Canadian Perinatal HIV surveillance program, started in 1992, is an active surveillance program in which pediatric centres and HIV clinics, where HIV-exposed or HIV-infected infants receive care, provide a yearly update on their perinatal cases. This national surveillance program reports on approximately 95% of the diagnosed HIV-exposed infants. Information collected includes; maternal data - risk factors for HIV acquisition, country of birth, ethnicity and ART in pregnancy; infant data - place and date of birth, infant's ART and HIV outcome. Cumulative data to December 2001 is reported. Combination antiretroviral therapy became available for children in Canada in 1996, so survival for birth cohorts pre- and post-1996 are compared.

RESULTS: The cumulative number of identified perinatally HIV-infected children in Canada is 394. For infants who were symptomatic at diagnosis (A,B or C) their five-year survival is to 64.4% compared to 89.8% for those who were either identified prior to delivery (E) or were asymptomatic at diagnosis (N), p<0.001. The 5 year survival rates for infants born before 1996 compared to those born in 1996 or later are 71.7% vs 91.7%, p = 0.002.

CONCLUSION: The 5yr survival rates pre-1996 are similar to those reported in the United States (75%), Italy (75%) and France (65%) for the same period. One study in the United States indicated that since 1996 there has been a decrease in mortality to 0.7% per year, which would be similar to these findings. This improvement in survival is likely due to several factors, such as, identification of infants before symptoms develop, prevention of PCP with chemoprophylaxis and use of combinations of antiretroviral agents.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Canada, Antiviral Agents, Survival Rate, United States, North America, Italy, France, Child, Infant, Human, Female, Pregnancy, mortality

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ThOrC1447