Aims: To define the burden of hospitalization due to two vaccine preventable infections, invasive pneumococcal disease (IPD) and varicella zoster (VZ), among HIV-infected children in the UK and Ireland.
Methods: Analysis of hospitalizations of HIV-infected children <18 years receiving pediatric care and reported to the Collaborative HIV Paediatric Study (CHIPS) between 1996 and 2011.
Results: Admissions for IPD and VZ combined accounted for approximately 5% of all hospital admissions for HIV-infected children each year. When compared to background rates for healthy children the admission rate ratio for HIV-infected children on combination ART (cART) was 16.7, 14.8 and 126.7 for IPD, varicella and herpes zoster respectively, and 156.7, 86.1 and 470 respectively for HIV-infected children not on cART. Those admitted with IPD or VZ were more likely to have CDC stage B/C at presentation with HIV than those without such admissions (36.8% for IPD, 29.7% for VZ and 22.1% for no IPD or VZ, p=0.006), and were more likely to subsequently commence cART (94.7%, 91.3% and 80.2% respectively, p=0.004).
Conclusions: There is a clear increased risk of admission with IPD or VZ in HIV-infected compared to uninfected children, magnified in those who have not yet commenced cART. It is anticipated that the introduction of new guidelines will result in improved vaccine uptake and thereby reduce the burden of IPD and VZ disease. Subsequent evaluation will assess the impact of these guidelines.
(C) 2014 by Lippincott Williams & Wilkins, Inc.