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Biomedical subjects

T Jonckheer

Publications and source records attributed to T Jonckheer.

15 recordsLinked to original sources

Families affected by HIV: parents' and children's characteristics and disclosure to the children.

The reduced risk of mother-to-child transmission due to improved HIV treatment has resulted in an increasing number of healthy children born to mothers living with HIV. The study's objective was to identify the number of parents or caregivers in a sample of persons living with HIV in Flanders, the number of HIV-affected children as well as specific family-related characteristics. Using a structured survey quantitative data were assessed on a total of 628 patients at three Flemish Aids reference centres. Qualitative data were collected in a small sub-sample of African caregivers living in Flanders. Twenty-seven per cent of the overall sample had children younger than 18 years, totalling 165 HIV-affected families with 279 children. Parents from developing countries had significantly more children than European parents. One hundred and eighty-two (68%) of all children were HIV-negative, while the HIV status of 75 (28%) was unknown. Disclosure rate was low: 26 (10%) children were aware of the parental HIV disease. The study shows that HIV-affected families have to deal with complex psychosocial issues such as migration, family illness, family secrecy around HIV and disclosure. Service implications are discussed.

Adaptation, Psychological↗

AIDS in children.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

HIV screening during pregnancy. Results of 2 attitude surveys on antenatal HIV screening in Belgium.

Two postal questionnaires were sent to Belgian gynaecologists in order to have information on their current policy of antenatal HIV screening. Of the 815 contacted, 446 (54.7%) completed the first questionnaire. 91.0% offers HIV testing in pregnancy; 49.1% to all pregnant women and 41.9% only to those with behavioural risks. Only 6.5% never offers HIV testing during pregnancy. The majority of these gynaecologists (79.8%) never had to deal with the problem of HIV-seropositivity in a pregnant woman. A second questionnaire with more detailed questions about HIV testing was sent to the identified respondents of the first survey. 237 of 340 (69.7%) responded. Of those, 48.9% perform HIV testing without informing the patient, whereas 43.4% always inform their patients before HIV testing. The majority performs the test at the first antenatal consultation (73.5%; 14.9% offers the test twice. These findings let us conclude that there is a need for recommendations concerning the policy of antenatal screening and information of patients.

AIDS Serodiagnosis↗

[Retinitis in an infant infected with HIV].

A 7 month-old HIV-infected infant of African origin was admitted to the hospital. A routinely performed fundoscopy showed the presence of an unilateral left retinitis. Urine culture was positive for cytomegalovirus (CMV). Treatment with AZT (3.5 mg/kg/6 hr) was started concomitantly with monthly 350 mg/kg gammaglobulin intravenous administration. The retinitis resolved after 3 weeks and no recurrence was observed after 4 months of follow-up. The difficulties in establishing a diagnosis and in evaluating a response to treatment are briefly discussed.

Cytomegalovirus Infections↗

Evaluation of the direct detection of group A beta-hemolytic streptococcal antigen in a pediatric population: comparison with the traditional culture technique.

An evaluation of the Directigen Group A Strep Test (DGAST) in comparison with the traditional culture technique, was carried out on 1907 throat specimens, obtained from pediatric patients suspected of having a group A beta-hemolytic streptococcal pharyngitis. Of the 344 specimens positive by culture, 277 were DGAST positive (sensitivity, 81%). Of the 1563 specimens negative by culture, 1511 were DGAST negative (specificity, 97%). Nineteen isolates of non-group A beta-hemolytic streptococci were recovered, primarily group C, B and G. The DGAST is easy to perform, rapid and very specific, but lower sensitivity indicates that a back up traditional culture is still necessary, especially in pediatric patients.

Adolescent↗

LAV/HTLV-III infection in children of African origin: experience in Belgium.

From December 1982 to June 1985, we diagnosed LAV/HTLV-III infection in 16 children of African origin living in Belgium or referred to one of the hospitals participating in this study. Diagnosis was proven in seven of them by isolation of virus of the LAV/HTLV-III group. In the nine others, LAV/HTLV-III infection was highly probable because of the presence of antibodies against the virus (seven subjects) or clinical and immunological evidence of immune deficiency associated with a parental history of LAV/HTLV-III infection (two subjects). Five of these children had a severe illness starting in the first months of life (range 20 days--4 months) and died within 4 months (range 19 days--10 months). Eight children presented later in life (mean age 35 months, range 2-66 months) with a milder and more chronic disease characterized by the presence of generalized lymphadenopathy (6/8), hepatomegaly (5/8), splenomegaly (5/8), interstitial pulmonary infiltration (4/8), parotid swelling (3/8), CSF lymphocytosis (3/5), diarrhoea without pathogen isolated (1/8) and fever (1/8). At least one of the parents of each child was of African origin. At the time of birth of their child two mothers and one father had an AIDS-related complex. After a mean period of 34 months (range 3-87 months) five fathers and six mothers had a symptomatic LAV/HTLV-III infection (AIDS or AIDS-related complex).

Acquired Immunodeficiency Syndrome↗

[Periarteritis nodosa in children. Diagnostic difficulties in 2 cases].

Periarteritis nodosa is a rare multisystemic disease whose diagnosis is difficult: diagnostic approach by biopsies in various involved organs is of poor efficacy; abdominal selective angiography yields a precise diagnosis in 50 to 60 of the studied cases as far as the celiac, mesenteric and renal circulations are investigated selectively. Digitalized intravenous angiography (DIVA) carried out in two patients of 9 and 13 years of age allowed to demonstrate aneurysm formations in hepatic, renal and cerebral circulations. Its true efficacy in the diagnosis of periarteritis nodosa of children remains to be determined.

Adolescent↗

Factors affecting antibody response of newborns to repeated administrations of the rotavirus vaccine RIT 4237.

The safety and immunogenicity of repeated doses of RIT 4237, an oral live attenuated rotavirus vaccine of bovine origin, as well as the influence of gastric acidity and maternal antibodies on the vaccine "take rate" were studied in newborns. The vaccine was given orally on the first day of life, at 1 month, and at 2 months of age. Fifty-seven newborns entered the study but only 36 completed the trial. No adverse reaction was observed after vaccination. Immune responses were evaluated by titrating pre- and postvaccination serum antibodies to RIT 4237 by a neutralization technique. Eight of 43 (18.6%) tested infants responded to the first dose of vaccine. Subsequently another six and 11 infants responded to the second and third dose, respectively. The total cumulative response after the third dose was 23 of 36 vaccinees (63.9%). The geometric mean neutralizing antibody titers was lower in responders than in nonresponders before the first dose of vaccine indicating that maternal antibodies interfered with vaccine "take." Since the RIT 4237 strain is acid sensitive, gastric pH was measured at the time of each vaccination. Mean pH values in responders were not significantly different than those found in nonresponders. Therefore, vaccine failures cannot be due to inactivation of the rotavirus vaccine in the stomach but instead they can be attributed to high levels of maternal antibodies. At each vaccination, additional subjects seroconverted. Therefore, a multiple dose scheme is advisable to obtain an optimal immune response.

Administration, Oral↗