Acute HIV infection in family

Background. Currently, there is an increase in the proportion of HIV-infected women of childbearing age. Infection can occur both before pregnancy, during pregnancy, and in the postpartum period. This creates risks of vertical transmission of the disease from mother to child. If infection of the mother occurs in the postpartum period against the background of lactation, the baby is infected through breast milk. Infants infected perinatally are delayed in development, suffer more often and more severely from opportunistic infections and oncological diseases, and their HIV infection rapidly progresses with the early development of immunodeficiency. Early diagnosis and perinatal prevention of infection are crucial.

Objective. To analyze the clinical, epidemiological and laboratory features of acute HIV infection in a mother and perinatally infected infant.

Materials and methods. We studied the medical records of an inpatient (form 003/y) and the results of our own clinical observation of the mother and baby who were treated at the Novokuznetsk City Clinical Infectious Diseases Hospital.

Results. A case of acute HIV infection in a mother and infant with clinical manifestations is presented. The mother was diagnosed for the first time 8 months after giving birth, the infection was associated with a change of sexual partner during lactation. The child was breastfed from birth. Symptoms of the disease in the child appeared 1 month after the onset of clinical manifestations in the mother, during the time when she stayed in the infectious diseases hospital. The child was diagnosed with HIV infection based on the detection of human immunodeficiency virus RNA in the blood.

Conclusion. In the above observation, a vertical route of infection of an infant was realized through the breast milk of a mother infected through sexual contact. The established HIV status of the mother was the reason for testing the child for HIV. The existing risk of infection of women during lactation with subsequent infection of the child during breastfeeding poses the task of organizing their periodic screening for HIV.

1. Bispo S., Chikhungu L., Rollins N., Siegfried N., Newell L. Postnatal HIV transmission in breastfed infants of HIV-infected women on ART: a systematic review and meta-analysis. Journal of the International AIDS Society. 2017; 20: 21251. http://www.jiasociety.org/index.php/jias/article/view/21251, http://dx.doi.org/10.7448/IAS.20.1.21251.

2. Penazzato M., Kasirye I., Ruel Th., Mukui I., et al. Antiretroviral postnatal prophylaxis to prevent HIV vertical transmission: present and future strategies. Journal of the International AIDS Society. 2023; 26: e26032. http://onlinelibrary.wiley.com/doi/10.1002/jia2.26032/full, |https://doi.org/10.1002/jia2.26032.

3. Altayeva А. Zh., Kosherova B. N., Serik B. Prevalence of HIV-infection among children's population. Medicine and ecology. 2019; (1): 36-43. (In Russ.)

4. Joint United Nations Programme on HIV/AIDS (UNAIDS) Global HIV and AIDS Statistics/ AVERT. 2019. URL: https://www.unaids.org/en/resources/fact-sheet.

5. Kozyrina N. V., Ladnaya N. N., Shakhgildyan V. I., Ivanova L. A., Narsia R. S., Dementieva L. A. Prevention of vertical HIV transmission and the problem of perinatal mortality of children born to women with HIV. Epidemiologiya i infekcionnye bolezni. Aktual'nye voprosy. Epidemiology and infectious diseases. Current issues. 2020; 10.3: 79-86. https://doi.org/10.18565/epidem.2020.10.3.79-86. (In Russ.)

6. Gusev D. A., Samarina A. V., Yastrebova E. B., Mozaleva O. I. Current state of prevention of mother-to-child HIV transmission in saintPetersburg. Journal Infectology. 2019; 11 (1): 58-64. https://doi.org/10.22625/2072-6732-2019-11-1-58-64. (In Russ.)

7. Drake A. L., Wagner A., Richardson B., JohnStewart G. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: A systematic review and metaanalysis. PLoSMed. 2014; 11 (2): e1001608. DOI: 10.1371/journal.pmed.1001608.

8. Ministry of Health of the Russian Federation. VICh-infektsiya u detey. Klinicheskie rekomendatsii MZ RF. Moscow, 2020. (In Russ.)

9. Dovgopoljuk E. S., Puzyreva L. V. Causes of adverse outcomes in children with perinatal contact for HIV infection. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2023; 12 (3): 71-78. DOI: https://doi.org/10.33029/2305-3496-2023-12-3-71-78. (In Russ.)

10. Hakizimana J.-C., Ivanov D. O., Yastrebova E. B., et al. Contemporary diagnosis of HIV infection in pediatrician’s practice. Pediatrician (St. Petersburg). 2020; 11 (3): 73-80. https://doi.org/10.17816/PED11373-80. (In Russ.)

11. Latysheva I. B., Voronin E. E. HIV infection in children. International scientific and practical conference "Topical issues of HIV infection in children". Conference materials. St. Petersburg: "Man and his health", 2023, 3-5. https://congress-ph.ru/istorija_1_1/2023/hiv09-2023/tezis. (In Russ.)

12. On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2023: State report. Moscow: Federal Service for Supervision of Consumer Rights Protection and Human Welfare4, 2024. 364 p. (In Russ.)

13. Ladnaya N. N., Pokrovsky V. V., Sokolova E. V., Chekryzhova D. G., Kirzhanova V. V. Prevalence of human immune deficiency virus infection in the territories of the Russian Federation in 2021. Epidemiology and Infectious diseases. Current items. 2022; 12 (3): 12-18. DOI: 10.18565/epidem.2022.12.3.12-8. (In Russ.)

14. WHO/UNAIDS. Guidelines for second generation HIV surveillance: an update: know your epidemic, 2013. 63 p. https://apps.who.int/iris/bitstream/handle/10665/85511/9789241505826_eng.pdf?sequence=1.

15. Denisenko V. B., Simovanyan E. M. Factors affecting the rate of immunosuppression development in children with HIV infection. Journal Infectology. 2022; 14 (1): 118-124. (In Russ. https://doi.org/10.22625/2072-6732-2022-14-1-118-124.

16. Joint United Nations Programme on HIV/AIDS (UNAIDS), 2023 https://www.unaids.org/sites/default/files/media_asset/2023-global-hivprevention-coalition-scorecards-key-findings_en.pdf.

17. Yunusov М. М. Features of infant feeding to prevent vertical transmission of HIV from mother to child. International Multidisciplinary Journal for Research & Development. 2023; 10 (09): 85-88. Retrieved from https://www.ijmrd.in/index.php/imjrd/article/view/68.