Guillén Sara, Prieto Luis, Jiménez de Ory Santiago, González-Granado Ignacio, González-Tomé María Isabel, Mellado María José, de José Maribel, Navarro María Luisa, Beceiro José, Roa Miguel Ángel, Muñoz María Ángeles, Tomás Ramos José
Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España.
Enferm Infecc Microbiol Clin. 2012 Mar;30(3):131-6. doi: 10.1016/j.eimc.2011.09.007. Epub 2011 Nov 25.
The number of children of immigrant origin in the last few years has increased the cohort of HIV-infected children in the Community of Madrid. The objectives of the study were to evaluate the epidemiological and clinical characteristics of the new diagnosed children and describe the different subtypes of HIV-1.
The new diagnosed children were analysed from the year 1997, divided into 3 periods: P1 (1997-2000), P2 (2001-2004), P3 (2005-2009). The regions and countries of origin, the clinical, immune and viral characteristics, as well as the response to treatment were analysed. The subtypes of HIV-1 were evaluated by phylogenetic analysis of protease genes and reverse transcriptase.
We identified 141 new diagnoses of HIV infection, the percentage of immigrant origin in P1 was (22.5%), P2 (50%) and P3 (68%). The origin had changed from Latin America in P1 to sub-Saharan Africa in P3. There were no differences between Spanish and immigrant children in the age at diagnosis, the CDC clinical stage A/B/C, viral load, percentage of CD4 at diagnosis and actual. Better viral response was more likely in immigrants after the first regimen of HAART (Highly active antiretroviral treatment) independently of the treatment received. A total of 66 subtypes were obtained, 24% were subtypes non-B (56% recombinants forms). All subtypes of Spanish children (43) and Latin American (5) were subtypes B, and all the children from sub-Saharan Africa (14) were subtypes non-B.
There were no differences between immigrants and Spanish children infected by HIV, except the different subtypes of HIV-1.
在过去几年中，马德里自治区移民家庭儿童数量的增加导致感染艾滋病毒儿童的队列扩大。本研究的目的是评估新诊断儿童的流行病学和临床特征，并描述HIV-1的不同亚型。
对1997年以来新诊断的儿童进行分析，分为3个时期：P1（1997 - 2000年）、P2（2001 - 2004年）、P3（2005 - 2009年）。分析其原籍地区和国家、临床、免疫和病毒学特征以及治疗反应。通过蛋白酶基因和逆转录酶的系统发育分析评估HIV-1的亚型。
我们确定了141例新诊断的HIV感染病例，P1时期移民儿童的比例为（22.5%），P2时期为（50%），P3时期为（68%）。来源地已从P1时期的拉丁美洲转变为P3时期的撒哈拉以南非洲。西班牙儿童和移民儿童在诊断年龄、美国疾病控制与预防中心临床分期A/B/C、病毒载量、诊断时及实际的CD4百分比方面没有差异。在接受第一个高效抗逆转录病毒治疗（HAART）方案后，移民儿童更有可能获得更好的病毒学反应，与接受的治疗无关。共获得66种亚型，24%为非B亚型（56%为重组形式）。所有西班牙儿童（43例）和拉丁美洲儿童（5例）的亚型均为B型，所有撒哈拉以南非洲儿童（14例）的亚型均为非B型。
除HIV-1的不同亚型外，感染艾滋病毒的移民儿童和西班牙儿童之间没有差异。
