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Ka'e AC, Santoro MM, Duca L, Chenwi CA, Ngoufack Jagni Semengue E, Nka AD, Etame NK, Togna Pabo WL, Beloumou G, Mpouel ML, Djupsa S, Takou D, Sosso SM, Tchidjou HK, Colizzi V, Halle-Ekane GE, Perno CF, Lewin S, Jones RB, Tiemessen CT, Ceccherini-Silberstein F, Fokam J. Evaluation of HIV-1 DNA levels among adolescents living with perinatally acquired HIV-1 in Yaounde, Cameroon: A contribution to paediatric HIV cure research in Sub-Saharan Africa. J Virus Erad 2024; 10:100367. [PMID: 38601701 PMCID: PMC11004643 DOI: 10.1016/j.jve.2024.100367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/17/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024] Open
Abstract
Background With the advent of antiretroviral therapy (ART), most children living with HIV in sub-Saharan Africa (SSA) are growing toward adolescence, with scarcity of evidence on the size of viral reservoirs to enhance paediatric cure research strategies. This study aims to compare HIV-1 proviral DNA levels according to virological response among adolescents living with perinatally acquired HIV-1 (ALPHIV) and identify associated-factors in the Cameroonian context. Methods In this observational cohort study, HIV-1 RNA viremia and CD4+ T-cell count were assessed through RT-PCR and flow cytometry respectively at three time-points over 18 months of observation. At the third time-point, 80 randomly-selected participants were classified as with viremia (≥50 HIV-1 copies/mL; n = 40) or without viremia (<50 HIV-1 copies/mL; n = 40); immune-competent (≥500 CD4+ T cells/mm3) or immunocompromised (<500 CD4+ T cells/mm3). Among these participants, total HIV-1 DNA load was quantified through droplet digital PCR using Bio-Rad QX200. Results Of the 80 randomly-selected adolescents, median [IQR] age was 15 (13-17) years, 56.2% were female, duration on ART was 9.3 [5.4-12.2] years. Among the 40 viremic ones (median viremia 7312 [283-71482]) HIV-1 copies/ml, 75.0% (30/40) were in virological failure (≥1000 HIV-1 copies/ml), while median of CD4 T cells were 494 [360-793] cell/mm3 with 48.8% (39/80) immunocompromised. No significant variation in HIV-1 RNA viremia and CD4 T cell count was observed between the three time-points, and 13.7% (11/80) adolescents remained aviremic and immune-competent throughout (stable adolescents). A positive and moderate correlation (r = 0.59; p < 0.001) was found between HIV-1 DNA levels and HIV- 1 RNA viremia. Regarding the CD4 T cell count, a negative and weak correlation (r = -0.28; p = 0.014) was found with HIV-1 DNA loads only among adolescents with viremia. Starting ART within the first year of life, ART for over 9 years and aviremia appear as predictors of low HIV-1 DNA loads. Conclusion Among ALPHIV, high HIV-1 RNA indicates an elevated viral reservoir size, representing a drawback to cure research. Interestingly, early ART initiation and longer ARTduration lead to sustained viral control and limited HIV-1 reservoir size. As limited size of viral reservoir appears consistent with viral control and immune competence, adolescents with sustained viral control (about 14% of this target population) would be candidates for analytical ART interruptions toward establishing paediatric post-treatment controllers in SSA.
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Affiliation(s)
- Aude Christelle Ka'e
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
- HIV Research for Cure Academy, International AIDS Society, Geneva, Switzerland
| | | | - Leonardo Duca
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Collins Ambe Chenwi
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Alex Durand Nka
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Naomi-Karell Etame
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Willy Leroi Togna Pabo
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Antwerp, Antwerp, Belgium
| | - Grace Beloumou
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Marie Laure Mpouel
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Yaounde I, Yaounde, Cameroon
| | - Sandrine Djupsa
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Desire Takou
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Samuel Martin Sosso
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | | | | | | | - Sharon Lewin
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - R Brad Jones
- HIV Research for Cure Academy, International AIDS Society, Geneva, Switzerland
- Weill Cornell Medicine Graduate School of Medical Sciences, New York, USA
| | - Caroline T. Tiemessen
- HIV Research for Cure Academy, International AIDS Society, Geneva, Switzerland
- Centre for HIV and STIs, National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Joseph Fokam
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- HIV Research for Cure Academy, International AIDS Society, Geneva, Switzerland
- University of Yaounde I, Yaounde, Cameroon
- Central Technical Group, National AIDS Control Committee, Yaoundé, Cameroon
- National HIV Drug Resistance Working Group, Ministry of Public Health, Yaounde, Cameroon
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2
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Ka’e AC, Nanfack AJ, Ambada G, Santoro MM, Takou D, Semengue ENJ, Nka AD, Bala MLM, Endougou ON, Elong E, Beloumou G, Djupsa S, Gouissi DH, Fainguem N, Tchouaket MCT, Sosso SM, Kesseng D, Ndongo FA, Sonela N, Kamta ACL, Tchidjou HK, Ndomgue T, Ndiang STM, Nlend AEN, Nkenfou CN, Montesano C, Halle-Ekane GE, Cappelli G, Tiemessen CT, Colizzi V, Ceccherini-Silberstein F, Perno CF, Fokam J. Inflammatory profile of vertically HIV-1 infected adolescents receiving ART in Cameroon: a contribution toward optimal pediatric HIV control strategies. Front Immunol 2023; 14:1239877. [PMID: 37646023 PMCID: PMC10461471 DOI: 10.3389/fimmu.2023.1239877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023] Open
Abstract
Antiretroviral therapy (ART) has improved the lifespan of people living with HIV. However, their immune system remains in a state of sustained activation/inflammation, which favors viral replication and depletion of helper T-cells with varying profiles according to ART-response. We herein sought to ascertain the inflammatory profile of adolescents living with perinatal HIV-1 infection (ALPHI) receiving ART in an African context. In this cross-sectional and comparative study among ART-experienced ALPHI in Yaoundé-Cameroon, HIV-1 RNA was measured by Abbott Real-time PCR; CD4 cells were enumerated using flow cytometry; serum cytokines were measured by ELISA; HIV-1 proviral DNA was genotyped by Sanger-sequencing; and archived drug resistance mutations (ADRMs) were interpreted using Stanford HIVdb.v9.0.1. Overall, 73 adolescents were enrolled (60 ALPHI and 13 HIV-1 negative peers) aged 15 (13-18) years; 60.00% were female. ART median duration was 92 (46-123) months; median viral load was 3.99 (3.17-4.66) RNA Log10 (copies)/mL and median CD4 count was 326 (201-654) cells/mm3. As compared to HIV-negative adolescents, TNFα was highly expressed among ALPHI (p<0.01). Following a virological response, inflammatory cytokines (IFNγ and IL-12), anti-inflammatory cytokines (IL-4 and IL-10) and inflammation-related cytokines (IL-6 and IL-1β) were highly expressed with viral suppression (VS) vs. virological failure (VF), while the chemokine CCL3 was highly expressed with VF (p<0.01). Regarding the immune response, the inflammatory cytokine TNFα was highly expressed in those that are immunocompetent (CD4≥500 cell/mm3) vs. immunocompromised (CD4<500 cell/mm3), p ≤ 0.01; while chemokine CCL2 was highly expressed in the immunocompromised (p<0.05). In the presence of ADRMs, IL-4 and CCL3 were highly expressed (p=0.027 and p=0.043 respectively). Among ART-experienced ALPHI in Cameroon, the TNFα cytokine was found to be an inflammatory marker of HIV infection; IFNγ, IL-1β, IL-6, and IL-12 are potential immunological markers of VS and targeting these cytokines in addition to antiretroviral drugs may improve management. Moreover, CCL3 and CCL2 are possible predictors of VF and/or being immunocompromised and could serve as surrogates of poor ART response.
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Affiliation(s)
- Aude Christelle Ka’e
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Aubin Joseph Nanfack
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Georgia Ambada
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Science, University of Yaounde 1, Yaounde, Cameroon
| | | | - Desire Takou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Alex Durand Nka
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Marie Laure Mpouel Bala
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Orphelie Ndoh Endougou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- School of Health Sciences, Catholic University of Central Africa, Yaounde, Cameroon
| | - Elise Elong
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Grace Beloumou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Sandrine Djupsa
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Davy Hyacinthe Gouissi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Nadine Fainguem
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Michel Carlos Tommo Tchouaket
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- School of Health Sciences, Catholic University of Central Africa, Yaounde, Cameroon
| | - Samuel Martin Sosso
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Daniel Kesseng
- Mother and Child Centre, Chantal BIYA Foundation, Yaounde, Cameroon
| | - Francis Ateba Ndongo
- Mother and Child Centre, Chantal BIYA Foundation, Yaounde, Cameroon
- Division of Operational Health Research, Ministry of Public Health, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
| | - Nelson Sonela
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Arnaud Cedric Lacmago Kamta
- Elisabeth Glaser Pediatric AIDS Foundation (EGPAF), Country-office, Yaoundé, Cameroon
- HIV Management Unit, Mfou District Hospital, Mfou, Cameroon
| | | | - Therese Ndomgue
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Celine Nguefeu Nkenfou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Carla Montesano
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Giulia Cappelli
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- National Research Council, Rome, Italy
| | - Caroline T. Tiemessen
- National Institute for Communicable Diseases and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vittorio Colizzi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
- Faculty of Science and Technology, Evangelic University of Cameroon, Bandjoun, Cameroon
| | | | - Carlo-Federico Perno
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Bambino Gesu Pediactric Hospital, Rome, Italy
| | - Joseph Fokam
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
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Deutou Wondeu AL, Talom BM, Linardos G, Ngoumo BT, Bello A, Ndassi Soufo AM, Momo AC, Doll C, Tamuedjoun AT, Kiuate JR, Cappelli G, Russo C, Perno CF, Tchidjou HK, Scaramella L, Galgani A. The COVID-19 wave was already here: High seroprevalence of SARS-CoV-2 antibodies among staff and students in a Cameroon University. J Public Health Afr 2023; 14:2242. [PMID: 36798849 PMCID: PMC9926561 DOI: 10.4081/jphia.2023.2242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/03/2022] [Indexed: 01/28/2023] Open
Abstract
Background Seroprevalence studies, to estimate the proportion of people that has been infected by SARS-CoV-2 are importance in African countries, where incidence is among the lowest in the world. Objective This study aimed at evaluating the exposure to SARS-CoV-2 within a university setting of Cameroon. Methods A cross-sectional study performed in December 2020 - December 2021, among students and staffs of the Evangelical University of Cameroon. COVID-19 antigen rapid detection test (RDT) was performed using Standard Q Biosensor, and one year after SARS-CoV-2 antibody-test was performed within the same population using RDT and chemiluminescence immunoassay (CLIA). Results 106 participants were enrolled (80% students), female sex was the most represented. Positivity to SARS-CoV-2 was 0.0% based on antigen RDTs. The seroprevalence of SARSCoV- 2 antibodies was estimated at 73.6% (95% CI. 64.5-81.0) for IgG and 1.9% (95% CI. 0.2-6.8) for IgM/IgG with RDTs, and 91.9% (95% CI. 84.7-96.4) for anti-nucleocapsid with CLIA. 95.3% (101) reported having developed at least one of the known COVID-19 symptoms (cough and headache being the most common). 90.3% (28) of people who experienced at least one of these symptoms developed IgG antibodies. 40.6% (43) of participants took natural herbs, whereas 55.7% (59) took conventional drugs. The most used herb was Zingiber officinale, while the most used drugs were antibiotics. Conclusion In this Cameroonian University community, SARS-CoV-2 seroprevalence is high, with a greater detection using advanced serological assays. This indicates a wide viral exposure, and the need to adequate control measures especially for those experiencing any related COVID-19 symptoms.
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Affiliation(s)
- Andrillene Laure Deutou Wondeu
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon,Department of Biology and Interdipartimental Center for Comparative Medicine, University of Rome Tor Vergata, Rome, Italy,Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon.
| | - Beatrice Metchum Talom
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | | | - Barnes Tanetsop Ngoumo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aïchatou Bello
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aurele Marc Ndassi Soufo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Aimé Cesaire Momo
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Christian Doll
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon,Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Jena, Jena, Germany,Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Corporate Member of Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Alaric Talom Tamuedjoun
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Jules-Roger Kiuate
- Laboratory of molecular biology and immunopathology, Evangelical University of Cameroon, Mbouo-Bandjoun, Cameroon
| | - Giulia Cappelli
- Institute for Biological Systems, National Research Council, Rome, Italy
| | | | | | | | - Lucia Scaramella
- Unit of Food Biotechnology, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M.Aleandri”, Rome, Italy
| | - Andrea Galgani
- Department of Biology and Interdipartimental Center for Comparative Medicine, University of Rome Tor Vergata, Rome, Italy
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4
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Tchidjou HK, Palandri L, Righi E, Monti M, Ricard J, Pouplin S, Tourneux P, Klein C. Symptom clusters helping the assessment of SARS-COV-2-infected children: Amiens cohort versus European data. Medicine (Baltimore) 2022; 101:e29524. [PMID: 35839021 PMCID: PMC9377676 DOI: 10.1097/md.0000000000029524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Since December 2019, the novel coronavirus (SARS-CoV-2) pandemic, caused >240 million cases and >5 million deaths. Given the current wider dissemination of pediatric cases, it is important to address questions regarding the clinical picture in children or if there are clinical patterns that may help us identify in an early stage what can be the prognosis and help clinicians with patient management. The study aimed to investigate in a French monocentric cohort and other European cohorts the presence of symptom clusterization and its possible connection to illness categories to help medical first-line screening and orientation in the pediatric emergency department (ED). METHODS We conducted a retrospective cohort study describing clinical, laboratory, and radiological characteristics of SARS-CoV-2-infected children admitted to pediatric ED to assess the presence of symptom clustering. A scoping review of the literature was performed to further investigate symptom clusters. RESULTS Of 1086 tested children, 48 tested positive to SARS-CoV-2. The clinical, laboratory, and radiological characteristics of our sample were fully described. Two distinct clusters of clinical phenotypes were identified as well as their potential association with illness categories in SARS-CoV-2-infected children. Comparison with similar European cohorts highlights how symptoms coming from the mucocutaneous-enteric, and the respiratory clusters are associated with a more severe clinical picture. CONCLUSIONS This study promotes the importance to identify early prognostic patterns to help clinicians in the decision process, especially in COVID-19 pediatric patients.
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Affiliation(s)
| | - Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Elena Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Marco Monti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Jannick Ricard
- Pediatric Emergency Services, Amiens University Hospital, Amiens, France
| | - Suzanne Pouplin
- Pediatric Emergency Services, Amiens University Hospital, Amiens, France
| | - Pierre Tourneux
- Pediatric Intensive Care Unit, Amiens University Hospital, Amiens, France
| | - Celine Klein
- Department of Pediatric Orthopedics, Amiens University Hospital, Amiens, France
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Tchidjou HK, Ghida G, Moreau F, Joseph C, Romeo B. Parents as coronavirus disease-19 carriers in intrafamily settings: Cases of severe forms in a family cluster. Int J Health Sci (Qassim) 2022; 16:37-39. [PMID: 35024033 PMCID: PMC8721212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The outbreak of coronavirus disease-19 (COVID-19) infection that started in China in December 2019 has subsequently spread too many countries worldwide with high contagiousness. Given the spread and the current debate on the management and origin of intrafamilial clusters of COVID-19, this case highlights how essential it has become to prompt quarantine for the whole family and any contact member who may be at risk of infection. For this, the management of family clusters requires specific guidelines that need to be prepared to help clinicians and families to better face the disease, especially the risk of developing severe forms. We reported a case and the management of severe forms of COVID-19 infection in an intrafamily cluster with different child and parent outcomes.
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Affiliation(s)
- Hyppolite K. Tchidjou
- Pediatric Emergency Services, University Hospital of Amiens-Picardie, France,Address for correspondence: Hyppolite K. Tchidjou, Pediatric Emergency Services, Amiens University Hospital, 1 Rue du Professeur Christian Cabrol, 80054 Amiens-France. Phone: +33 0322087550. Fax: +33 0322089665. E-mail:
| | - Ghostine Ghida
- Neonatal Intensive Care Unit, University Hospital of Amiens-Picardie, France
| | - Francois Moreau
- Neonatal Intensive Care Unit, University Hospital of Amiens-Picardie, France
| | - Cédric Joseph
- Department of Infectious Disease, University Hospital of Amiens-Picardie, France
| | - Bernard Romeo
- Pediatric Emergency Services, University Hospital of Amiens-Picardie, France
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Abstract
Since 2019 coronavirus disease (COVID-19) is highly contagious with a high mortality rate. France has taken strict infection control measures. According to the report by the Center for Disease Control and Prevention, children are less affected with COVID-19 and seem to have less severe disease than adults. We reported the first confirmed infant case of co-infection with SARS-CoV-2 and Citrobacter koseri urinary infection in 6-week-old child admitted on 25 March 2020 with mild symptoms in the Pediatric COVID Unit of Amiens University Hospital, France.
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Affiliation(s)
- Hyppolite K Tchidjou
- Correspondence: Hyppolite K. Tchidjou, Pediatric Emergency Services Department, Amiens University Hospital, Urgence Pédiatrique CHU-Amiens; 1 Rue du Professeur Christian Cabrol, 80054 Amiens, France. E-mail <>
| | - Bernard Romeo
- Pediatric Emergency Services Department, Amiens University Hospital, 80000 Amiens, France
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Giancristoforo S, Diociaiuti A, Tchidjou HK, Lucchetti MC, Carnevale C, Rotunno R, D'Argenio P, El Hachem M. Successful topical treatment of anal giant condylomata acuminata in an infant. Dermatol Ther 2020; 33:e13624. [PMID: 32431022 DOI: 10.1111/dth.13624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/24/2020] [Accepted: 05/16/2020] [Indexed: 11/27/2022]
Abstract
Anogenital condylomata acuminata are induced by human papillomavirus (HPV) and they rarely manifest in immunocompetent children. Therapeutic options depend on patient's age and general conditions and extension of the lesions. However, management is still a challenge and recurrences are frequent. Cryotherapy, laser, and surgical treatments in children are painful and frequently require general anesthesia. Imiquimod is a topical immune response modifier and constitutes a noninvasive alternative for the treatment of anogenital condylomata acuminata. Here, we report an infant admitted to our hospital with a giant vegetative papillomatous lesion on the perianal region surrounded by small satellites papules. PCR for HPV confirmed the clinical diagnosis of giant condylomata acuminata due to HPV type 6. The child has been successfully treated with topical 5% imiquimod cream without side effects. Although topical imiquimod is not licensed for pediatric age, this report highlights the potential benefits of its use in selected pediatric cases.
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Affiliation(s)
| | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | | | - Claudia Carnevale
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Roberta Rotunno
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizia D'Argenio
- Division of Immunology and Infectious Diseases, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Rome, Italy
| | - Maya El Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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8
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Tchidjou HK, Palandri L, Vescio FM, Pezzotti P, Bernardi S. The unexposed world of the (HIV-negative) exposed. HIV Med 2019; 21:e5-e6. [PMID: 31642577 DOI: 10.1111/hiv.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Lucia Palandri
- Medicine and Surgery Department, University of Parma, Parma, Italy
| | - Fenicia M Vescio
- Epidemiology Unit, Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
| | - Patrizio Pezzotti
- Epidemiology Unit, Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
| | - Stefania Bernardi
- Unit of Immune and Infectious Disease, University Department of Pediatrics DPUO, Bambino Gesù Children's Hospital, Rome, Italy
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9
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Bracaglia G, Mancinelli L, Ranno S, Del Chierico F, Tchidjou HK, Porzio O, Onetti Muda A, Putignani L. Globalization effects on the reports of non-endemic parasitosis in Italy. Microbiol Med 2018. [DOI: 10.4081/mm.2018.7932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Protozoa and helminths are responsible for several intestinal parasite infections (IPIs). Generally, helminth infections are very unsafe but scarcely reported in high-income countries, while protozoa and helminth co-infections are usually reported in children living in inadequate hygienic-sanitary conditions and in rural areas. However, the impact of growing globalization, intense travelling, international adoptions and high levels of immigrants and refugees has significantly incremented the incidence of orofecal parasitosis in non-endemic areas. Although most IPs clear without treatment when population, even children, emigrate from endemic to different geographical areas, some IPIs such as strongyloidiasis may persist for decades as subclinical infections or as low-grade disease with nonspecific clinical manifestations, unless to reappear under impairment conditions. Herein we report an unusual case of Giardia lamblia and Trichuris spp. chronic asymptomatic co-infection in a healthy adopted Romanian child, living in a Central Italy rural area, and a hidden case of Strongyloides stercoralis in an adopted Burundian child, resident in South Italy, long misdiagnosed as a recurrent undefined dermatitis. Our report suggests the need to review primary care practitioner guidelines and children’s hospital procedures for appropriate IPIs screening and follow-up, hence providing new screening and prevention strategies, in agreement with international guidelines.
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Romani L, Pane S, Severini C, Menegon M, Foglietta G, Bernardi S, Tchidjou HK, Onetti Muda A, Palma P, Putignani L. Challenging diagnosis of congenital malaria in non-endemic areas. Malar J 2018; 17:470. [PMID: 30551740 PMCID: PMC6295090 DOI: 10.1186/s12936-018-2614-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/05/2018] [Indexed: 01/19/2023] Open
Abstract
Background Congenital malaria is usually defined as the detection of asexual forms of Plasmodium spp. in a blood sample of a neonate during perinatal age if there is no possibility of postpartum infection by a mosquito bite. The incidence of congenital malaria is highly variable and seems related to several factors, such as different diagnostic methods for Plasmodium spp. detection, and area in which the epidemiologic analyses are performed. In non-endemic countries, cases of congenital malaria are rare. Hereby, a case of a congenital malaria in an HIV exposed child is reported. Case presentation A 2-month-old male child was admitted to Bambino Gesù Children’s Hospital due to anaemia and exposure to HIV. He was born prematurely in Italy by cesarean section at 34 weeks’ gestation after a bicorial, biamniotic pregnancy by a migrant woman from Nigeria. He was the first of non-identical twins. Combined with anaemia, spleen and liver enlargement was noted, malaria was hypothesized. Malaria laboratory panel was performed on the newborn, mother and other twin blood samples, as follows: (i) malaria rapid diagnostic test (RDT); (ii) Giemsa-stained thick and thin blood smears for Plasmodium spp. identification and parasitaemia titration; (iii) molecular screening and typing of Plasmodium spp. by multiplex qualitative PCR assay based on 18S rRNA gene. Genotyping of Plasmodium falciparum isolates from mother and child was performed by neutral microsatellite and highly polymorphic marker amplification. Conclusions The maternal RDT sample was negative, while the infant RDT was positive; in both cases microscopy of blood smears and PCR showed infection with P. falciparum. Two of the genotypic molecular markers displayed different allelic variants between the two samples. This difference could imply infection multiplicity of the mother during the pregnancy, possibly harbouring more than one isolate, only one of them being transmitted to the newborn while the other persisting in the mother’s blood. Because of the increasing number of pregnant women coming from endemic areas for malaria, an accurate anamnesis of infant’s mother, and the inclusion of Plasmodium spp. research into TORCH screenings for mother-infant pair at birth, aiming at reducing morbidity and mortality associated to the disease might be suitable.
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Affiliation(s)
- Lorenza Romani
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Stefania Pane
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Carlo Severini
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - Michela Menegon
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - Gianluca Foglietta
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Stefania Bernardi
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Hyppolite K Tchidjou
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Andrea Onetti Muda
- Department of Laboratories, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Paolo Palma
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Lorenza Putignani
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy. .,Unit of Human Microbiome, Bambino Gesù Children's Hospital, Viale San Paolo 15, 00146, Rome, Italy.
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Tchidjou HK, Vescio MF, Serafinelli J, Giampaolo R, Jenkner A, Tadonkeng MC, Avellis L, Fiocchi A, Pezzotti P, Rezza G, Rossi P. Susceptibility to allergy in adoptive children: a cross-sectional study at "Bambino Gesù Children's Hospital". Ital J Pediatr 2018; 44:3. [PMID: 29301554 PMCID: PMC5755410 DOI: 10.1186/s13052-017-0440-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 12/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Prevalence of allergy has steeply increased during the past few decades, particularly in high-income countries. The development of atopy could present different characteristics in internationally adopted children with regard to incidence, specific patterns of allergies and timing of occurrence. We aimed to investigate the occurrence of allergic diseases among adopted children in Italy. Methods We collected demographic information, preadoption immunization data, infectious diseases screening results, immunological status, and performed hematological and biochemical tests according to a standardized protocol in 108 adopted children. Results At initial visit (mean age was 5.7 ± 3.2 years), 48 children displayed elevated total serum IgE levels with a prevalence of 56.5% (95%CI: 0.45; 0.67). The prevalences of children screened positive for one or more food allergens and inhalants were 30.1% (95%CI: 19.9%; 42.0%) and 34.3% (95%CI: 23.3%; 46.6%) respectively, only 9 children exhibited abnormal absolute eosinophil counts, 23 (21.3%) had a parasitic infection and 60 (55.6%) had received at least one dose of vaccine. Conclusions Children without medical records or with a past medical history suggestive of atopy should perform a thorough allergy evaluation at the time of adoption. Our study offers also a glimpse at the vaccination status and immune-allergic profiles of recent migrant children in Italy.
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Affiliation(s)
- Hyppolite K Tchidjou
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Maria Fenicia Vescio
- Epidemiology Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Jessica Serafinelli
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Rosaria Giampaolo
- Department of Pediatric Medicine, University Department of Pediatrics (DPUO), Children's Hospital Bambino Gesù, Rome, Italy
| | - Alessandro Jenkner
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | | | - Luca Avellis
- Epidemiology Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Fiocchi
- Division of Allergy, University Department of Pediatrics (DPUO), Children's Hospital Bambino Gesù, Rome, Italy
| | - Patrizio Pezzotti
- Epidemiology Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Rezza
- Epidemiology Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Rossi
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
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Bernardini R, Aufieri R, Detcheva A, Recchia S, Cicconi R, Amicosante M, Montesano C, Rossi P, Tchidjou HK, Petrunov B, Orefici G, Mattei M. Neonatal protection and preterm birth reduction following maternal group B streptococcus vaccination in a mouse model. J Matern Fetal Neonatal Med 2016; 30:2844-2850. [PMID: 27973991 DOI: 10.1080/14767058.2016.1265932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Evaluate effects of maternal immunization in a mouse model of Group B Streptococcus (GBS) vaginal colonization using clinical isolates. MATERIALS AND METHODS Female pregnant mice were immunized with heat-killed GBS 21 days before pregnancy and were inoculated intravaginally with GBS cultures (5 × 107 CFU twice a day for three days) from the 16th day of pregnancy. Gestation period and mice survival were monitored. Maternal anti-GBS IgG levels have been determined by ELISA analysis in vaccinated, unvaccinated mothers and newborns. RESULTS Maternal immunization before pregnancy provided protection to newborns for three of the four GBS strains used. Evaluation of the immunogenicity showed that this vaccination induced higher levels of IgG in vaccinated compared to unvaccinated dams and the presence of antibodies in the offspring at embryonic and postnatal age, and a Th1 response and high levels of IgG2a subclass antibody and IFN-γ were detected. A significant reduction of preterm births was observed in vaccinated mothers (p< 0.05). CONCLUSIONS Our finding suggest that vaccinated mothers could protect their progeny from GBS infection and preterm birth through passive immunization. The proposed mouse model may represent a noninvasive and effective tool to investigate pathogenetic mechanisms of GBS ascending infection and for vaccine protection studies.
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Affiliation(s)
- R Bernardini
- a Centro Servizi Interdipartimentale-STA, University of Rome "Tor Vergata" , Rome , Italy
| | - R Aufieri
- b Division of Neonatology and Neonatal Intensive Care , Casilino General Hospital , Rome , Italy
| | - A Detcheva
- c National Center of Infectious and Parasitic Diseases - NCIPD , Sofia , Bulgaria
| | - S Recchia
- d Istituto Superiore di Sanità - ISS , Rome , Italy
| | - R Cicconi
- a Centro Servizi Interdipartimentale-STA, University of Rome "Tor Vergata" , Rome , Italy
| | - M Amicosante
- e Department of Biomedicine and Prevention , University of Rome "Tor Vergata" , Rome , Italy.,f ProxAgen Ltd., Sofia , Bulgaria
| | - C Montesano
- g Department of Biology , University of Rome "Tor Vergata" , Rome , Italy
| | - P Rossi
- h Department of Experimental Medicine and Surgery , University of Rome "Tor Vergata" , Rome , Italy
| | - H K Tchidjou
- i University-Hospital Pediatric Department (DPUO), Bambino Gesù Children Hospital , Rome , Italy
| | - B Petrunov
- c National Center of Infectious and Parasitic Diseases - NCIPD , Sofia , Bulgaria
| | - G Orefici
- d Istituto Superiore di Sanità - ISS , Rome , Italy
| | - M Mattei
- a Centro Servizi Interdipartimentale-STA, University of Rome "Tor Vergata" , Rome , Italy.,g Department of Biology , University of Rome "Tor Vergata" , Rome , Italy
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Palma P, Zangari P, Alteri C, Tchidjou HK, Manno EC, Liuzzi G, Perno CF, Rossi P, Bertoli A, Bernardi S. Early antiretroviral treatment (eART) limits viral diversity over time in a long-term HIV viral suppressed perinatally infected child. BMC Infect Dis 2016; 16:742. [PMID: 27938348 PMCID: PMC5148894 DOI: 10.1186/s12879-016-2092-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 12/03/2016] [Indexed: 11/23/2022] Open
Abstract
Background HIV genetic diversity implicates major challenges for the control of viral infection by the immune system and for the identification of an effective immunotherapeutic strategy. With the present case report we underline as HIV evolution could be effectively halted by early antiretroviral treatment (eART). Few cases supported this evidence due to the difficulty of performing amplification and sequencing analysis in long-term viral suppressed patients. Here, we reported the case of limited HIV-1 viral evolution over time in a successful early treated child. Case presentation A perinatally HIV-1 infected infant was treated within 7 weeks of age with zidovudine, lamivudine, nevirapine and lopinavir/ritonavir. At antiretroviral treatment (ART) initiation HIV-1 viral load (VL) and CD4 percentage were >500,000 copies/ml and 35%, respectively. Plasma genotypic resistance test showed a wild-type virus. The child reached VL undetectability after 33 weeks of combination antiretroviral therapy (cART) since he maintained a stable VL <40copies/ml. After 116 weeks on ART we were able to perform amplification and sequencing assay on the plasma virus. At this time VL was <40 copies/ml and CD4 percentage was 40%. Again the genotypic resistance test revealed a wild-type virus. The phylogenetic analysis performed on the HIV-1 pol sequences of the mother and the child revealed that sequences clustered with C subtype reference strains and formed a monophyletic cluster distinct from the other C sequences included in the analysis (bootstrap value >90%). Any major evolutionary divergence was detected. Conclusions eART limits the viral evolution avoiding the emergence of new viral variants. This result may have important implications in host immune control and may sustain the challenge search of new personalized immunotherapeutic approaches to achieve a prolonged viral remission. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2092-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paolo Palma
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy. .,Research Unit in Congenital and Perinatal Infections, Children's Hospital Bambino Gesù, Rome, Italy.
| | - Paola Zangari
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy.,Research Unit in Congenital and Perinatal Infections, Children's Hospital Bambino Gesù, Rome, Italy
| | - Claudia Alteri
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Hyppolite K Tchidjou
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy
| | - Emma Concetta Manno
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy
| | - Giuseppina Liuzzi
- Clinical Department, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
| | - Carlo Federico Perno
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Paolo Rossi
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy
| | - Ada Bertoli
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Stefania Bernardi
- Academic Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, P.zza Sant'Onofrio, 4-00165, Rome, Italy.
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Tchidjou HK, Gargiullo L, Vescio F, Giampaolo R, Nicolosi L, Finocchi A, Rossi P. Immunization status of internationally adopted children in Rome, Italy. Niger J Clin Pract 2015; 18:307-11. [PMID: 25772909 DOI: 10.4103/1119-3077.151714] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS International adoption medicine is a relatively new specialty in pediatrics that has emerged to address the specific health care needs of internationally adopted children in high-income countries. This study ascertains the seroprotection rate for vaccine-preventable diseases, especially against pneumococcal diseases. PATIENTS AND METHODS We evaluated 67 internationally adopted children that reached the International Adoption Unit of Bambino Gesù Children's Hospital, Rome-Italy. We collected demographic information, data from preadoption immunization records, results of laboratory testing for immunity to vaccine-preventable diseases (tetanus, pneumococcus, hepatitis B, hemophilus influenzae type b (Hib), measles), as well as results of screening for HIV, hepatitis C, quantiferon, immunological and nutritional status. RESULTS For children that had received ≥3 vaccine doses of tetanus, overall protection was 94% of 31 vaccinated children; with 1-2 vaccine doses for hepatitis B and Hib respectively, protection was 45% of 29 vaccinated children and 63% of 8 vaccinated children, respectively. For children with one or more doses of measles vaccine, protection was 63% of 32 vaccinated children. Regarding pneumococcus vaccine (documented for eight children), 88% of children with one or more doses of vaccine had developed protective immunity. CONCLUSIONS International adoptees without a valid vaccine record need to undergo a complete schedule in accordance with their age and should receive all the vaccines in the adoptive country's schedule.
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Affiliation(s)
- H K Tchidjou
- University Department of Pediatrics (DPUO), Children's Hospital, Rome, Italy
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Tchidjou HK, De Matteis A, Di Iorio L. Celiac Disease in an Adoptive Child with Recurrent Giardia Infection. Int J Health Sci (Qassim) 2015. [DOI: 10.12816/0024126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tchidjou HK, De Matteis A, Di Iorio L, Finocchi A. Celiac Disease in an Adoptive Child with Recurrent Giardia Infection. Int J Health Sci (Qassim) 2015; 9:193-197. [PMID: 26309440 PMCID: PMC4538898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Celiac disease (CD) is an inflammatory disease of the small intestine. A complete management and differential diagnosis of such disease includes food intolerances, intestinal infections, and irritable bowel syndrome. We describe an 8-years-old adoptive girl from Congo with negative medical history. Patient followed for recurrent abdominal pain and diarrhea associated to Giardia infection, unresponsive to antiparasitic therapy. Persistence of symptoms despite antiparasitic therapy, prompted us to perform: 1- Blood screening of Celiac disease, which was negative; 2- Genetic evaluation of celiac disease, which revealed the presence of HLA-DQ2 heterodimer; and 3- Esophagogastroduodenoscopy, which showed duodenal villous atrophy and crypt hyperplasia, associated with Helicobacter Pylori infection. The child was treated in accordance with international recommendations using a Gluten-free diet and specific antibiotics, which lead to the resolution of the symptoms. Our patient's clinical history seems peculiar, considering that, recurrent Giardiasis may mimic the symptoms of Celiac disease and may simulate clinical and histological picture of active Celiac disease. Early diagnosis may help prevent the complications of untreated celiac disease.
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Affiliation(s)
- Hyppolite K. Tchidjou
- University Department of Pediatrics (DPUO), Children’s Hospital Bambino Gesù, Rome, Italy
| | - Arianna De Matteis
- University Department of Pediatrics (DPUO), Children’s Hospital Bambino Gesù, Rome, Italy
| | - Laura Di Iorio
- University Department of Pediatrics (DPUO), Children’s Hospital Bambino Gesù, Rome, Italy
| | - Andrea Finocchi
- University Department of Pediatrics (DPUO), Children’s Hospital Bambino Gesù, Rome, Italy
- Chair of Pediatrics, University of Tor-Vergata, Rome, Italy
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Palma P, Romiti ML, Montesano C, Santilli V, Mora N, Aquilani A, Dispinseri S, Tchidjou HK, Montano M, Eriksson LE, Baldassari S, Bernardi S, Scarlatti G, Wahren B, Rossi P. Therapeutic DNA vaccination of vertically HIV-infected children: report of the first pediatric randomised trial (PEDVAC). PLoS One 2013; 8:e79957. [PMID: 24312194 PMCID: PMC3842924 DOI: 10.1371/journal.pone.0079957] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 09/26/2013] [Indexed: 01/09/2023] Open
Abstract
Subjects Twenty vertically HIV-infected children, 6–16 years of age, with stable viral load control and CD4+ values above 400 cells/mm3. Intervention Ten subjects continued their ongoing antiretroviral treatment (ART, Group A) and 10 were immunized with a HIV-DNA vaccine in addition to their previous therapy (ART and vaccine, Group B). The genetic vaccine represented HIV-1 subtypes A, B and C, encoded Env, Rev, Gag and RT and had no additional adjuvant. Immunizations took place at weeks 0, 4 and 12, with a boosting dose at week 36. Monitoring was performed until week 60 and extended to week 96. Results Safety data showed good tolerance of the vaccine. Adherence to ART remained high and persistent during the study and did not differ significantly between controls and vaccinees. Neither group experienced either virological failure or a decline of CD4+ counts from baseline. Higher HIV-specific cellular immune responses were noted transiently to Gag but not to other components of the vaccine. Lymphoproliferative responses to a virion antigen HIV-1 MN were higher in the vaccinees than in the controls (p = 0.047), whereas differences in reactivity to clade-specific Gag p24, RT or Env did not reach significance. Compared to baseline, the percentage of HIV-specific CD8+ lymphocytes releasing perforin in the Group B was higher after the vaccination schedule had been completed (p = 0.031). No increased CD8+ perforin levels were observed in control Group A. Conclusions The present study demonstrates the feasibility, safety and moderate immunogenicity of genetic vaccination in vertically HIV-infected children, paving the way for amplified immunotherapeutic approaches in the pediatric population. Trial registration clinicaltrialsregister.eu _2007-002359-18IT
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Affiliation(s)
- Paolo Palma
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital “Bambino Gesu”, Rome, Italy
- * E-mail:
| | - Maria Luisa Romiti
- Department of Medicine, Chair of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
| | - Carla Montesano
- Department of Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Veronica Santilli
- Department of Medicine, Chair of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
| | - Nadia Mora
- Department of Medicine, Chair of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
| | - Angela Aquilani
- Department of Medicine, Chair of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
| | - Stefania Dispinseri
- Unit of Viral Evolution and Transmission, San Raffaele Scientific Institute, Milan, Italy
| | - Hyppolite K. Tchidjou
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital “Bambino Gesu”, Rome, Italy
| | - Marco Montano
- Chair of Infectious Diseases, University of Rome “Tor Vergata”, Rome, Italy
| | - Lars E. Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Department of Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
- School of Health Science, City University, London, United Kingdom
| | - Stefania Baldassari
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital “Bambino Gesu”, Rome, Italy
| | - Stefania Bernardi
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital “Bambino Gesu”, Rome, Italy
| | - Gabriella Scarlatti
- Unit of Viral Evolution and Transmission, San Raffaele Scientific Institute, Milan, Italy
| | - Britta Wahren
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Rossi
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital “Bambino Gesu”, Rome, Italy
- Department of Medicine, Chair of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
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Tchidjou HK, Maria Martino A, Goli LPK, Diop Ly M, Zekeng L, Samba M, Maiolo S, Palma P, Pontrelli G, Mancino G, Rossi P, Colizzi V. Paediatric HIV infection in Western Africa: the long way to the standard of care. J Trop Pediatr 2012; 58:451-6. [PMID: 22529318 DOI: 10.1093/tropej/fms015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In sub-Saharan Africa, newborns and children continue to suffer from insufficient access to early diagnosis and antiretroviral (ARV) treatments. A survey had been conducted in Burkina Faso, Ghana and Ivory Coast, from January 2010 to February 2011 to identify the major challenges regarding HIV prophylaxis and treatment of children in western Africa. The results of this survey highlight that only a small proportion of HIV-exposed newborns receive ARV prophylaxis. However, this problem is often not perceived at the national level. The problem could be faced by improving the communication process between the peripheral health services and the national procurement system. Moreover, supporting the development of local pharmaceutical industries could facilitate the availability of child-sized drugs, contextualized to the socio-cultural needs of such area, adequate not only in terms of efficacy, safety and tolerability, but also in terms of palatability, storage, distribution and cost.
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Affiliation(s)
- Hyppolite K Tchidjou
- University Department of Pediatrics (DPUO), 'Bambino Gesù' Children's Hospital, Rome, Italy.
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Pontrelli G, Cotugno N, Amodio D, Zangari P, Tchidjou HK, Baldassari S, Palma P, Bernardi S. Renal function in HIV-infected children and adolescents treated with tenofovir disoproxil fumarate and protease inhibitors. BMC Infect Dis 2012; 12:18. [PMID: 22269183 PMCID: PMC3306735 DOI: 10.1186/1471-2334-12-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 01/23/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Kidney disease is an important complication in HIV infected people, and this may be related to infection or antiretroviral therapy (ART). Our aim is to assess renal function in HIV infected paediatric patients, who may be particularly affected and are likely to take ART for longer than adults, and investigate the long term role of Tenofovir Disoproxil Fumarate (TDF) alone or co-administered with Ritonavir-boosted Protease Inhibitors (PI). METHODS Serum creatinine, phosphate and potassium levels, with estimated Glomerular Filtration Rate (eGFR), had been prospectively evaluated for 2 years in a cohort of HIV infected children and adolescents (age 9-18) on ART, and data analyzed according to the exposure to TDF or simultaneous TDF and PI. RESULTS Forty-nine patients were studied (57% female, mean age 14). Sixty-three percent were treated with ART containing TDF (Group A), and 37% without TDF (Group B); 47% with concomitant use of TDF and PI (Group C) and 53% without this combination (Group D). The groups didn't differ for age, gender or ethnicity. The median creatinine increased in the entire cohort and in all the groups analyzed; eGFR decreased from 143.6 mL/min/1.73 m2 at baseline to 128.9 after 2 years (p = 0.006) in the entire cohort. Three patients presented a mild eGFR reduction, all were on TDF+PI. Phosphatemia decreased significantly in the entire cohort (p = 0.0003) and in TDF+PI group (p = 0.0128) after 2 years. Five patients (10%) developed hypophosphatemia (Division of Acquired Immune Deficiency AE grade 1 or 2), and four of them were on TDF+PI. CONCLUSIONS Renal function decrease and hypophosphatemia occur over time in HIV infected children and adolescents on ART. The association with co-administration of TDF and PI appears weak, and further studies are warranted.
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Affiliation(s)
- Giuseppe Pontrelli
- University Department of Pediatrics, Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio, 4, 00165 Rome, Italy.
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Santilli V, Mora N, Aquilani A, Tchidjou HK, Pontrelli G, De Vito R, Lombardi A, Bernardi S, Palma P. Burkitt's lymphoma mimicking EBV disease as first sign of vertical HIV infection in an adolescent. Ital J Pediatr 2010; 36:34. [PMID: 20416074 PMCID: PMC2873400 DOI: 10.1186/1824-7288-36-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 04/23/2010] [Indexed: 11/19/2022] Open
Abstract
Burkitt's Lymphoma (BL) rarely represents the first clinical manifestation of vertical HIV infection in adolescent in Western Europe. We report the case of a 17 year-old boy with two week history of fever and enlarged cervical lymph nodes firstly misdiagnosed as EBV infection, subsequently diagnosed as Burkitt's Lymphoma and vertical HIV infection.
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Affiliation(s)
- Veronica Santilli
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Nadia Mora
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Angela Aquilani
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Hyppolite K Tchidjou
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Giuseppe Pontrelli
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Rita De Vito
- Unit of Anatomical Pathology- Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Stefania Bernardi
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
| | - Paolo Palma
- DPUO, University Department of Pediatrics- Children's Hospital Bambino Gesù, Rome, Italy
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