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Abstract
Untreated, Asymptomatic Congenital HIV Infection Twenty-Two Years After Birth. A Unique Case Report
Manfredi R.1
Introduction: Also perinatal HIV infection may have a non-progressive course. However, a 22-year-long asymptomatic congenital HIV infection was never reported.
Methods: Our patient (p) was born in October 1982 to an i.v. drug user mother, and identified as HIV-infected concurrently with her mother in 1984. Vertical HIV transmission was confirmed, by exclusion of other risk factors: administration of blood derivatives, or sexual abuse.
Results: Since birth, our p had an uneventful childhood, with regular achievement of all developmental milestones, save a slight delay in menarche presentation (at the age of 15). At the present 22-year age, her height is 165 cm,and body weight is 56 Kg. No HIV-associated signs and symptoms became apparent throughout the entire follow-up, save a migrant micropolyadenopathy. Laboratory evaluation, performed at least quarterly, did not show notable modifications, save physiological changes of the leukocyte differential, moving into adult age. In particular, CD4+ count never falled <612 cells/µL, and viremia had its peak at the age of 12 (4.09 Log10 HIV-RNA copies/mL). Clinical and laboratory markers of HIV infection pose our p at stage A-1 (CDC, 1994). Monthly i.v. immunoglobulins were administered until the age of 14 (when our p became aware of HIV infection), but no antiretroviral therapy was prescribed.
Conclusions: Simple survival beyond adolescence remains rare among p vertically-infected in the pre-therapy era, while a non- progressive congenital infection lasting asymptomatically until adult age has not comparable literature evidences. A stable, almost completely symptom-free HIV disease with a steadily favorable immunologic picture, low viral load, and no need of anti-HIV therapy 22 years after birth, makes our report absolutely unique. Such a long perinatal HIV course raises relevant questions about laboratory evaluation, anti-HIV therapy, and psychosocial implications. The natural history of non-progressive HIV infection from infancy into adult age and its correlates, needs further investigation.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe9.1B01
Suggested Citation
" Manfredi R.
Untreated, Asymptomatic Congenital HIV Infection Twenty-Two Years After Birth. A Unique Case Report.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe9.1B01"
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