Document 2821
 DOCN  M94A2821
 TI    Intra-venous gammaglobulin: a weapon against bacterial infections in HIV
       infected children?
 DT    9412
 AU    Della Negra M; Castro IO; Queiroz W; Yu CL; Soraggi Neto C; Paste AA;
       Vazquez CM; Inst. Infectol. Emilio Ribas, Sao Paulo, Brazil.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):217 (abstract no. PB0297). Unique
       Identifier : AIDSLINE ICA10/94369754
 AB    OBJECTIVE: To evaluate the effects of discontinuity of the
       administration of intra-venous Gamma globulin (IVGG) and the possibility
       of the use of Trimethoprim-Sulfamethoxazole (TMP-SMZ) in the prevention
       of bacterial infections among pediatric AIDS patients. METHODS: In our
       service, 80 pediatric AIDS patients (P2-CDC) with CD4 count > 200/mm3
       receive IVGG monthly (500mg/kg). Some of them receive also TMP-SMZ (20
       mg/Kg daily) as chemoprophylaxis for Pneumocystis carinii Pneumonia. For
       reasons beyond our control there was a break in the supply of IVGG for 3
       consecutive months in 1993. We analyzed the changes in the occupation
       rate of the 12 hospital beds bound for Pediatric AIDS Patients 3 months
       before, during the cessation of IVGG and 3 months after the
       re-establishment of its administration. We also analyzed if the patients
       who got bacterial infections during the lack of IVGG were receiving or
       not TMP-SMZ. RESULTS: The occupation rate of the beds of the Pediatric
       ward increased from 18.1% in the 3 months before the lack of IVGG to
       50.4% during its cessation and 35.8% in the 3 months after the
       re-establishment of the supply of IVGG. These rates follow the same
       pattern when analyzing only the hospitalizations due to bacterial
       infections. More than half of the children who got bacterial infections
       were receiving TMP-SMZ. Severe bacterial infections (as septicemia,
       meningitis, etc.) were infrequent during all this study. DISCUSSION: The
       break in the supply of IVGG changed significantly the occupation rate in
       the pediatric ward in our center. These registers did not reach the
       baseline because it took some time to reestablish our routine after the
       replacement of IVGG administration. It seemed clear that the use of
       TMP-SMZ did not show a significant role in the prevention of bacterial
       infections. Otherwise, TMP-SMZ could be the responsible for the absence
       of severe bacterial infections. A better cost analysis comparing IVGG
       administration and hospitalization should be done. Despite the high
       cost, we believe that IVGG can provide them a better quality of life.
 DE    AIDS-Related Opportunistic Infections/PREVENTION & CONTROL  Bacterial
       Infections/COMPLICATIONS/*PREVENTION & CONTROL  Bed Occupancy  Child
       Drug Evaluation  Human  HIV Infections/*COMPLICATIONS/IMMUNOLOGY
       Immunoglobulins, Intravenous/ADMINISTRATION & DOSAGE/ECONOMICS/
       *THERAPEUTIC USE  Pneumonia, Pneumocystis carinii/PREVENTION & CONTROL
       Quality of Life  Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC
       USE  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).