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Year : 2008  |  Volume : 11  |  Issue : 1  |  Page : 38-40

Slow progression of paediatric HIV disease: Is it a chance phenomenon or selective adaptation?

Department of Paediatrics, Aminu Kano University Teaching Hospital, P.M.B. 3452, Kano, Nigeria

Correspondence Address:
S I Adeleke
Department of Paediatrics, Aminu Kano Teaching Hospital, PMB 3452, Kano
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Source of Support: None, Conflict of Interest: None

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Background: Disease progression in human immunodeficiency virus / Acquired immunodeficiency syndrome (HIV/AIDS) is affected by several factors both external and internal to the human hosts. The European populations the chemokine-cell receptor variant CCR5 "Delta 32" is the genetic determinant of HIV disease progression that is believed to have been selected for the general population by exposure to antigens closely interlinked to HIV like Yersina pestis or small pox virus. It is thought 1 that among the African population, the selection is induced by HIV over time. Objective: To present two cases of mother to child transmitted HIV highlighting the possible increasing prevalence of slow disease progression. Results: Both patients were female, had lost one parent more than 10years earlier but had the other surviving parent exhibiting slow HIV disease progression. A possible inheritance of the genetic factors associated with slow disease progression in a recessive x-linked mendellian pattern and role of the high prevalence of HIV within the Sub-Saharan setting as the selective pressure favoring the establishment of the currently known immunologic and genetic factors influencing HIV disease progression was postulated. Conclusion: The cases have shown that there are slow progressors among the HIV patients and, therefore, there is the need for clinicians to be aware of these groups of patients. It is important to have an in depth of immunologic and genetic approach to examine the prevalence and possibility of adaptive selection for immunogenetic protectors of HIV progression in the region.

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