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Deborah Cohan

Publications and source records attributed to Deborah Cohan.

5 recordsLinked to original sources
PubMed2005

Temporal trends in early clinical manifestations of perinatal HIV infection in a population-based cohort.

CONTEXT: The effect of early antiretroviral therapy (ART) on the early progression of perinatal human immunodeficiency virus (HIV) infection is not well defined. OBJECTIVE: To examine early disease progression and survival in a population-based cohort with perinatal HIV infection in relation to year of birth and use of ART. DESIGN, SETTING, AND PATIENTS: Retrospective study of temporal trends in early progression of perinatal HIV infection among 205 HIV-infected children in Northern California born between January 1, 1988, and December 31, 2001, and followed up through age 3 years. MAIN OUTCOME MEASURES: Prevalence of and age at progression to a first US Centers for Disease Control and Prevention category C diagnosis relative to year of birth, type of ART, and age at initiation of therapy. RESULTS: Of 205 children, 134 (65%) received ART and/or Pneumocystis jiroveci pneumonia prophylaxis. By age 3 years, 81 (40%) progressed to a category C diagnosis, 41 (51%) of whom died. Untreated children were significantly more likely to progress to a category C diagnosis (62% [44/71] untreated vs 28% [37/134] treated children, P<.001); none of 23 infants who received triple ART progressed to category C. However, even without triple ART, very early mono/dual ART (by age 2 months vs 3-4 months) was associated with delayed and decreased progression to category C (P = .02). Of 33 children born between January 1, 1996, and December 31, 2001, only 7 (21%) progressed to category C (P = .02 compared with 1988-1995), 6 of 7 of whom received no therapy. More recent year of birth and more advanced therapy were associated with improved survival. CONCLUSIONS: This population-based cohort demonstrated decreased early HIV progression and improved survival at age 3 years, associated with more advanced therapy. Although limited by small sample size, the findings suggest that very early treatment, even without triple ART, was associated with improved outcome.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Perinatal HIV: special considerations.

The percentage of AIDS cases among women--particularly women of color--in the United States is increasing yearly. Despite this increase, there has been a relatively steady decline in the number of AIDS cases occurring perinatally. Regardless of the reasons HIV-infected couples choose to become pregnant, studies indicate that providing support, such as contraceptive counseling and assisted reproduction techniques, can improve the health outcome in the face of HIV-related challenges. Issues specific to antiretroviral therapy, including viral resistance, pregnancy outcomes, and adverse fetal effects, complicate the treatment of perinatal HIV. Postpartum case is yet another area that requires special consideration when supporting HIV-infected parents and children. The growing body of data on pregnancy and HIV may indicate a rising commitment to research of and support for the unique challenges HIV-infected families face. This article was adapted from an IAS-USA interactive case-based program, Cases on the Web, in November 2003.

Acquired Immunodeficiency Syndrome↗