December 17, 2015
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Foreign-born adoptees with HIV show few serious health conditions

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Adopted children with HIV from foreign countries faced no increased risk for severe medical issues such as immunosuppression, according to research in Pediatric Infectious Disease Journal.

“We hypothesized that HIV-infected foreign-born adoptees may have health needs that are distinct from HIV-uninfected adoptees; they may be more prone to infectious diseases because of underlying immunosuppression, growth abnormalities because of low birth weight and chronic disease, and behavioral problems and mental illness because of HIV-associated neurocognitive effects and social stigma,” Elizabeth R. Wolf, MD, of the department of pediatrics at the University of Washington School of Medicine, and colleagues said. “In this cohort of HIV-infected adoptees … serious acute medical conditions were uncommon.”

The researchers studied 79 foreign-born, HIV-infected adoptees and refugees aged 20 years and younger. Patient data from Seattle Children’s Hospital and Colorado Children’s Hospital collected from 2004 to May 2013 was retrospectively analyzed. Baseline data was collected during the first 6 months each patient was on site, while longitudinal data was collected during annual follow-up visits. Ninety percent of study participants were from Africa, with 71% from Ethiopia.

The researchers wrote that the most frequently identified medical problems were dermatologic and gastrointestinal, including tinea, molluscum contagiosum, parasite infections and diarrhea. The researchers considered these conditions mild.

Wolf and colleagues noted that upon adoption only 1% of the cohort was severely immunosuppressed. The majority (75%) were receiving ART, of which 76% had suppressed viral load. The investigators also said 48% of the cohort had either mental health issues or behavioral issues; 50% experienced educational delays.

“In contrast to the low prevalence of serious medical conditions, mental health and behavioral diagnoses were common, particularly during follow-up,” Wolf and colleagues wrote. “The stigma associated with HIV infection itself is also known to contribute to poor psychological outcomes, including posttraumatic stress disorder.” – by David Costill

Disclosure: The researchers report no relevant financial disclosures.