INVASIVE PNEUMOCOCCAL INFECTIONS IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED CHILDREN

Invasive pneumococcal infection (IPI) is the most common serious bacte rial infection in human immunodeficiency virus (HIV)-infected children . Data from a population-based pediatric HIV surveillance project were used to determine the incidence of IPI in HIV-infected children and t o conduct a case-control study assessing potential risk factors for IP I in HIV-infected children. There were 50 episodes of IPI and a cumula tive incidence of 6.1 cases/100 patient-years through age 7 years. Chi ldren with IPI were more likely to have a prior AIDS diagnosis (odds r atio, 4.2; 95% confidence interval, 1.2-15.1) and higher levels of IgG and IgM (P = .01) than were controls. In a separate case-control stud y, the manifestations of IPI in HIV-infected children were compared wi th those in HIV-negative controls. Focal complication rates in the 2 g roups did not differ; however, HIV-infected children were less likely than controls to have leukocytosis (P < .001) and more likely to have isolates with penicillin resistance (P = .03).