Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T08:49:10.002Z Has data issue: false hasContentIssue false

5 - Routine pediatric care

Published online by Cambridge University Press:  23 December 2009

By
Elaine Abrams ,
Rachel Y. Moon ,
Lisa-Gaye Robinson  and
Russell B. Van Dyke
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Elaine Abrams
Affiliation:
Department of Pediatrics, Harlem Hospital Center and College of Physicians and Surgeons, Columbia University, New York, NY
Rachel Y. Moon
Affiliation:
Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC
Lisa-Gaye Robinson
Affiliation:
Department of Pediatrics, Harlem Hospital Center and College of Physicians and Swgeons, Columbia University, New York, NY
Russell B. Van Dyke
Affiliation:
Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Institutes of Health, Bethesda, Maryland
Get access

Summary

Introduction

HIV infection is a chronic illness with diverse clinical manifestations and psychosocial challenges. The routine care of HIV-infected children demands a dedicated multidisciplinary approach from a variety of health care professionals including medical sub-specialists, nurses, psychiatrists, psychologists, dentists, social workers and case managers. The HIV primary care provider, while ensuring health maintenance and preventing disease, must serve as the coordinator of an array of services crucial to the management of these children in the context of the family. Important management considerations attend the care of both HIV-exposed children and those children ultimately identified as HIV-infected.

Care of the HIV-exposed infant

Routine care for the infant born to an HIV-infected mother should begin well before the infant's birth. Clinicians should collaborate with the mother's primary care providers to minimize the risk of HIV transmission. Care of the infant after birth includes continued interventions to reduce the risk of HIV infection, as well as HIV diagnostic evaluations and routine infant care (Table 5.1). Care of the HIV-exposed newborn in the hospital begins with a thorough maternal history, including HIV disease status [HIV RNA concentration (viral load), CD4+ lymphocyte count, and HIV-related complications), receipt of interventions to prevent mother-to-child transmission (e.g., antiretroviral prophylaxis, cesarean delivery before labor and before ruptured membranes), and history of other infections (e.g., syphilis, herpes simplex virus, hepatitis B and C, cytomegalovirus, toxoplasmosis, gonorrhea, or tuberculosis (TB)).

Type
Chapter
Information
Handbook of Pediatric HIV Care , pp. 134 - 176
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Connor, E. M., Sperling, R. S., Gelber, R.et al.Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N. Engl. J. Med. 1994;331(18):1173–1180.CrossRefGoogle ScholarPubMed
Wade, N. A., Birkhead, G. S., Warren, B. L.et al.Abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus. N. Engl. J. Med. 1998;339(20):1409–1414.CrossRefGoogle ScholarPubMed
Wade, N., Birkhead, G., French, P. T.Short courses of zidovudine and perinatal transmission of human immunodeficiency virus. N. Engl. J. Med. 1999;340:1042–1043.Google Scholar
Working group on antiretroviral therapy and medical management of infants, children and adolescents with human immunodeficiency virus infection. Antiretroviral therapy and medical management of the human immunodeficiency virus-infected child. Pediatrics 1998;102(4):1005–1062. (Most recent revision of the guidelines available at AIDSinfo.nih.gov. Accessibility verified October 29, 2005.)
Cunningham, C. K., Charbonneau, T. T., Song, K.et al.Comparison of human immunodeficiency virus 1 deoxyribonucleic acid polymerase chain reaction and qualitative and quantitative ribonucleic acid polymerase chain reaction in human immunodeficiency virus 1-exposed infants. Pediatr. Infect. Dis. J., 1999;18:30–35.CrossRefGoogle Scholar
Delamare, C., Burgard, M., Mayaux, M. J.et al.human immunodeficiency virus-1 ribonucleic acid detection in plasma for the diagnosis of infection in neonates. The French Pediatric human immunodeficiency virus Infection Study Group. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 1997;15(2):121–125.CrossRefGoogle Scholar
Benjamin, D. K., Miller, W. C., Fiscus, S. A.et al.Rational testing of the human immunodeficiency virus-exposed infant. Pediatrics 2001;108(1):E3.CrossRefGoogle Scholar
Dunn, D. T., Brandt, C. D., Krivine, A.et al.The sensitivity of human immunodeficiency virus-1 deoxyribonucleic acid polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. acquired immune deficiency syndrome 1995;9:F7–F11.Google Scholar
Centers for Disease Control and Prevention. Recommended childhood immunization schedule – United States, 2002. Morb. Mortal. Wkly. Rep. 2002;51(2):31–33.
Centers for Disease Control and Prevention. Recommendations of the Advisory Committee on Immunization Practices: use of vaccines and immune globulins in persons with altered immunocompetence. Morb. Mortal. Wkly Rep. 1993;42 (No relative risk-4).
Centers for Disease Control and Prevention. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1991;40.
Centers for Disease Control and Prevention. Poliomyelitis prevention in the United States – updated recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 2000;49(No. relative risk-5).
Technical Consultative Group to the World Health Organization on the Global Eradication of Poliomyelitis. “Endgame” issues for the global poliomyelitis eradication initiative. Clin. Infect. Dis. 2002;34:72–77.CrossRef
Centers for Disease Control and Prevention. Measles, mumps, and rubella – vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1998;47(No. relative risk-8).
Centers for Disease Control. 1994 classification system for human immunodeficiency virus infection in children less than 13 years of age. Morb. Mortal. Wkly Rep. 1994;43(No. relative risk-12): 1–10.
Committee on Infectious Diseases and Committee on Pediatric acquired immune deficiency syndrome, American Academy of Pediatrics. Measles immunization in human immunodeficiency virus-infected children. Pediatrics 1999;103:1057–1060.CrossRef
Centers for Disease Control and Prevention. Prevention of varicella – updated recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1999;48 (No. relative risk-6).
Centers for Disease Control and Prevention. Update: vaccine side effects, adverse reactions, contraindications, and precautions – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1996;45 (No. relative risk-12).
Centers for Disease Control and Prevention. Preventing pneumococcal disease among infants and young children – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 2000;49 (No. relative risk-9).
King, J. C., Vink, P. E., Farley, J. J., Smilie, M., Parks, M., Lichenstein, R.Safety and immunogenicity of three doses of a five-valent pneumococcal conjugate vaccine in children younger than 2 years with and without human immunodeficiency virus infection. Pediatrics 1997;99:575–580.CrossRefGoogle ScholarPubMed
King, J. C., Vink, P. E., Farley, J. J.Comparison of the safety and immunogenicity of a pneumococcal conjugate with a licensed polysaccharide vaccine in human immunodeficiency virus and non-human immunodeficiency virus-infected children. Pediatr. Infect. Dis. J. 1996;15:192–196.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Prevention of Hepatitis A through active or passive immunization – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1999;48: (No. relative risk-12).
Advisory Committee on Immunization Practices. Prevention and control of influenza – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 2001;50 (relative risk-4).
O'Brien, W. A., Grovit-Ferbas, K., , Namazi A.et al.Human immunodeficiency virus type 1 replication can be increased in peripheral blood of seropositive patients after influenza vaccination. Blood 1995; 86:1082–1089.Google ScholarPubMed
Ramilo, O., Hicks, P. J., Borvak, J.et al.T cell activation and human immunodeficiency virus replication after influenza immunization of infected children. Pediatr. Infect. Dis. J. 1996;15:197–203.CrossRefGoogle ScholarPubMed
Staprans, S. K., Hamilton, B. L., Follansbee, S. E.et al.Activation of virus replication after vaccination of human immunodeficiency virus-1 infected individuals. J. Exp. Med. 1995;182:1727–1737.CrossRefGoogle Scholar
Sullivan, P. S., Hanson, D. L., Dworkin, M. S.et al.Effect of influenza vaccination on disease progression among human immunodeficiency virus-infected persons. acquired immune deficiency syndrome 2000;14:2781–2785.Google Scholar
Kroon, F., Dissel, J., Jong, J., Zwinderman, K., Furth, R.Antibody response after influenza vaccination in human immunodeficiency virus-infected individuals: a consecutive 3-year study. Vaccine 2000; 18:3040–3049.CrossRefGoogle Scholar
King, J. J., Fast, P., Zangwill, K.et al.Safety, vaccine virus shedding and immunogenicity of trivalent, cold-adapted, live attenuated influenza vaccine administered to human immunodeficiency virus-infected and noninfected children. Pediatr. Infect. Dis. J. 2001;20:1124–1131.CrossRefGoogle ScholarPubMed
King, J. J., Treanor, J., Fast, P.et al.Comparison of the safety, vaccine virus shedding, and immunogenicity of influenza virus vaccine, trivalent, types A and B, live cold-adapted, administered to human immunodeficiency virus (human immunodeficiency virus)-infected and non-human immunodeficiency virus-infected adults. J. Infect. Dis. 2000;181:725–728.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. The role of Bacille Calmette–Guerin vaccine in the prevention and control of tuberculosis in the United States – a joint statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1996;45 (No. relative risk-4).
Centers for Disease Control and Prevention. Guidelines for the prevention of opportunistic infections among human immunodeficiency virus-infected persons – 2002 recommendations of the U. S. Public Health Service and the Infectious Diseases Society of America. Morb. Mortal. Wkly Rep. 2002; 51 (No. relative risk-8): 1–52.
Harries, A. D., , Maher D., tuberculosis/human immunodeficiency virus: A Clinical Manual. Geneva, Switzerland: World Health Organization, 1996.Google Scholar
World Health Organization. Special Programme on acquired immune deficiency syndrome and expanded programme on immunizations: joint statement – consultation on human immunodeficiency virus (human immunodeficiency virus) and routine childhood immunizations. Wkly Epidemiol. Rec. 1987;62:297–299.
Centers for Disease Control and Prevention. Recommendations for the use of Lyme disease vaccine – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1999;48 (No. relative risk-7).
Centers for Disease Control and Prevention. Prevention of plague – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly, Rep. 1996;45 (No. relative risk-14).
Centers for Disease Control and Prevention. Human rabies prevention – United States, 1999 – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1999;48 (No. relative risk-1).
Centers for Disease Control and Prevention. Rotavirus vaccine for the prevention of rotavirus gastroenteritis among children – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1999;48 (No. relative risk-2).
Centers for Disease Control and Prevention. Typhoid immunization – recommendations of the Advisory Committee on Immunization Practices (Advisory Committee on Immunization Practices). Morb. Mortal. Wkly Rep. 1994;43 (No. relative risk-14).
Centers for Disease Control and Prevention. Health information for international travelers 2001–2002. Atlanta: US Department of Health and Human Services, Public Health Service, 2001.
McKinney, R. E., Robertson, J. W.Effect of human immunodeficiency virus infection on the growth of young children. Duke Pediatric acquired immune deficiency syndrome Clinical Trials Unit. J. Pediatr. 1993;123(4):579–582.
Abrams, E. J., Matheson, P. B., Thomas, P. A.et al.Neonatal predictors of infection status and early death among 332 infants at risk of human immunodeficiency virus-1 infection monitored prospectively from birth. Pediatrics 1995;96:451–458.Google ScholarPubMed
Moye, J., Rich, K. C., Kalish, L. A.et al.Natural history of somatic growth in infants born to women infected by human immunodeficiency virus. J. Pediatr 1996;128:58–69.CrossRefGoogle ScholarPubMed
DeMartino, M., Tovo, P. A., Galli, L.et al.Puberty in perinatal human immunodeficiency virus-1 infection: a multicenter longitudinal study of 212 children. acquired immune deficiency syndrome 2001;15(12):1527–1534.Google Scholar
Arpadi, S. M., Cuff, P. A., Horlick, M., , Wang J., Kotler, D. P.Lipodystrophy in human immunodeficiency virus-infected children is associated with high viral load and low cluster of differentiation4+ -lymphocyte count and cluster of differentiation4+ -lymphocyte percentage at baseline and use of protease inhibitors and stavudine. J. Acquir. Immune Defic. Syndr. 2001;27(1):30–34.CrossRefGoogle Scholar
Melvin, A. J., Lennon, S., Mohan, K. M., Purnell, J. Q.Metabolic abnormalities in human immunodeficiency virus type 1-infected children treated and not treated with protease inhibitors. acquired immune deficiency syndrome Res. Hum. Retroviruses 2001;17(12):1117–1123.Google Scholar
Diamond, G. W.Developmental problems in children with human immunodeficiency virus infection. Ment. Retard. 1989;27(4):213–217.Google Scholar
Brown, L. K., Lourie, K. J., Pao, M.Children and adolescents living with human immunodeficiency virus and acquired immune deficiency syndrome: a review. J. Child Psychol. Psychiatry 2000;41(1):81–96.CrossRefGoogle ScholarPubMed
Mofenson, L. M., Korelitz, J., Meyer, W. A.et al.The relationship between serum human immunodeficiency virus type 1 (human immunodeficiency virus-1) ribonucleic acid level, cluster of differentiation4 lymphocyte percent, and long-term mortality risk in human immunodeficiency virus-1 infected children. National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group. J. Infect. Dis. 1997;175:1029–1038.CrossRefGoogle Scholar
Abrams, E. J., Weedon, J., Steketee, R. W.et al.Association of human immunodeficiency virus viral load early in life with disease progression among human immunodeficiency virus-infected infants. J. Infect. Dis. 1998;178:101–108.CrossRefGoogle Scholar
Shearer, W. T., Quinn, T. C., LaRussa, P.et al.Viral load and disease progression in infants infected with human immunodeficiency virus type 1. N. Engl. J. Med. 1997;336:1337–1342.CrossRefGoogle ScholarPubMed
Palumbo, P. E., Raskino, C., Fiscus, S.et al.Predictive value of quantitative plasma human immunodeficiency virus ribonucleic acid and cluster of differentiation4+ lymphocyte count in human immunodeficiency virus-infected infants and children. J. Am. Med. Assoc. 1998;279(10):756–761.CrossRefGoogle Scholar
Palella, F. J., Delaney, K. M., Moorman, A. C.et al.Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N. Engl. J Med. 1998;338:853–861.CrossRefGoogle ScholarPubMed
Mussini, C., Pezzotti, P., Govoni, A.et al.Discontinuation of primary prophylaxis for Pneumocystis carinii pneumonia and toxoplasmic encephalitis in human immunodeficiency virus type-I-infected patients: the changes in opportunistic prophylaxis study. J. Infect. Dis. 2000;181:1635–1642.CrossRefGoogle ScholarPubMed
Dankner, W. M., Lindsey, J. C., Levin, M. J.Correlates of opportunistic infections in children infected with the human immunodeficiency virus managed before highly active antiretroviral therapy. Pediatr. Infect. Dis. J. 2001;20:40–48.CrossRefGoogle ScholarPubMed
Para, M. F., Finkelstein, D., Becker, S., Dohn, M., Walawander, A., Black, J. R.Reduced toxicity with gradual initiation of trimethoprim-sulfamethoxazole as primary prophylaxis for Pneumocystis carinii pneumonia: acquired immune deficiency syndrome Clinical Trials Group 268. J. Acquir. Immune Defic. Syndr. 2000;24:337–343.CrossRefGoogle Scholar
Leoung, G. S., Stanford, J. F., Giordano, M. F.et al.Trimethoprim-sulfamethoxazole (TMP-SMZ) dose escalation versus direct rechallenge for Pneumocystis carinii pneumonia prophylaxis in human immunodeficiency virus-infected patients with previous adverse reaction to TMP-SMZ. J. Infect. Dis. 2001;184:992–997.CrossRefGoogle ScholarPubMed
Kletzel, M., Beck, S., Elser, J., Shock, N., Burks, W.Trimethoprim sulfamethoxazole oral desensitization in hemophiliacs infected with human immunodeficiency virus with a history of hypersensitivity reactions. Am. J. Dis. Child 1991;145:1428–1429.Google ScholarPubMed
Schneider, M. M. E., Borleffs, J. C. C., , Stolk R. P.et al.Discontinuation of prophylaxis for Pneumocystis carinii pneumonia in human immunodeficiency virus-1-infected patients treated with highly active antiretroviral therapy. Lancet 1999; 353:201–203.CrossRefGoogle Scholar
Quiros, Lopez Bernaldo de J. C., Miro, J. M., Pena, J. M.et al.Randomized trial of the discontinuation of primary and secondary prophylaxis against Pneumocystis carinii pneumonia after highly active antiretroviral therapy in patients with human immunodeficiency virus infection. N. Engl. J. Med. 2001;344:159–167.CrossRefGoogle Scholar
Havlir, D. V., Dube, M. P., Sattler, F. R.et al.Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both. N. Engl. J. Med. 1996;335:392–398.CrossRefGoogle ScholarPubMed
National Institute of Child Health and Human Development intravenous immunoglobulin Study Group. Intravenous immune globulin for the prevention of bacterial infection in children with symptomatic human immunodeficiency virus infection. N. Engl. J. Med. 1991;325:73–80.CrossRef
Spector, S. A., Gelber, R. D., McGrath, N.et al.A Controlled trial of intravenous immune globulin for the prevention of serious bacterial infections in children receiving zidovudine for advanced human immunodeficiency virus infection. N. Engl. J. Med. 1994;331:1181–1187.CrossRefGoogle ScholarPubMed
McKinsey, D. S., Wheat, L. F., Cloud, G. A.et al.Itraconazole prophylaxis for fungal infections in patients with advanced human immunodeficiency virus infection: randomized, placebo-controlled, double-blind study. Clin. Infect. Dis. 1999;28:1049–1056.CrossRefGoogle ScholarPubMed
Frenkel, L. D., Gaur, S., Tsolia, M.et al.Cytomegalovirus infection in children with acquired immune deficiency syndrome. Rev. Infect. Dis. 1990;12 (Suppl 7): S820–S826.CrossRefGoogle Scholar
Nigro, G., Krzystofiak, A., Gattinara, G.et al.Rapid progression of human immunodeficiency virus diseases in children with cytomegalovirus DNAemia. acquired immune deficiency syndrome 1996;10:1127–1133.Google ScholarPubMed
Mussi-Pinhata, M. M., Yamamoto, Y., Figueiredo, L. T. M.et al.Congenital and perinatal cytomegalovirus infection in infants born to mothers infected with human immunodeficiency virus. J. Pediatr. 1998;132:285–290.CrossRefGoogle ScholarPubMed
Kovacs, A., Schlucter, M., Easley, K.et al.Cytomegalovirus infection and human immunodeficiency virus-1 disease progression in infants born to human immunodeficiency virus-1-infected women. N. Engl. J. Med. 1999; 341: 77–84.CrossRefGoogle Scholar
Spector, S. A., McKinley, G. F., Lalezari, J. P.et al.Oral ganciclovir for the prevention of cytomegalovirus disease in persons with acquired immune deficiency syndrome. N. Engl. J. Med. 1996;334:1491–1497.CrossRefGoogle Scholar
Cordell, R. L., Addiss, D. G.Cryptosporidiosis in child care settings: a review of the literature and recommendations for prevention and control. Pediatr. Infect. Dis. J. 1994;13:310–317.Google ScholarPubMed
Flanigan, T., Whalen, C., Turner, J.et al.Cryptosporidium infection and cluster of differentiation4 counts. Ann. Intern. Med. 1992;116:840–842.CrossRefGoogle Scholar
Cello, J. P., Acquired immunodeficiency syndrome cholangiopathy: spectrum of disease. Am. J. Med. 1989;86:539–546.CrossRefGoogle Scholar
Holmberg, S. D., Moorman, A. C., Bargen, J. C.et al.Possible effectiveness of clarithromycin and rifabutin for cryptosporidiosis chemoprophylaxis in human immunodeficiency virus disease. J. Am. Med. Assoc. 1998;279:384–386.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Pregnancy outcomes following systemic prenatal acyclovir exposure: June 1, 1984–June 30, 1993. Morb. Mortal. Wkly Rep. 1993;42:806–809.
Plancoulaine, S., Abel, L., Beveren, M.et al.Human herpesvirus 8 transmission from mother to child and between siblings in an endemic population. Lancet 2000;356:1062–1065.CrossRefGoogle Scholar
, Yeung L T F, , King S M, , Roberts E A.Mother-to-infant transmission of hepatitis C virus. Hepatology 2001;34:223–229.CrossRefGoogle Scholar
Havens, J. F., Mellins, C. A., Hunter, J. Psychiatric Aspects of human immunodeficiency virus/acquired immune deficiency syndrome in childhood and adolescence. In Rutter, M., Taylor, E. eds Child and Adolescent Psychiatry: Modern Approaches, 4th edn. Oxford, UK: Blackwell, 2001:828–841.Google Scholar
Mellins, C. A., Brackis-Cott, E., Dolezal, C., Richards, A., Nicholas, S., Abrams, E. J.Patterns of human immunodeficiency virus status disclosure to perinatally infected human immunodeficiency virus-positive children and subsequent mental health outcomes. Clin. Child Psychol. Psychiatry. 2001;7:101–114.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Routine pediatric care
    • By Elaine Abrams, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Surgeons, Columbia University, New York, NY, Rachel Y. Moon, Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, Lisa-Gaye Robinson, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Swgeons, Columbia University, New York, NY, Russell B. Van Dyke, Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.007
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Routine pediatric care
    • By Elaine Abrams, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Surgeons, Columbia University, New York, NY, Rachel Y. Moon, Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, Lisa-Gaye Robinson, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Swgeons, Columbia University, New York, NY, Russell B. Van Dyke, Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.007
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Routine pediatric care
    • By Elaine Abrams, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Surgeons, Columbia University, New York, NY, Rachel Y. Moon, Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, Lisa-Gaye Robinson, Department of Pediatrics, Harlem Hospital Center and College of Physicians and Swgeons, Columbia University, New York, NY, Russell B. Van Dyke, Department of Pediatrics, Tulane University Health Sciences Center, New Orleans, LA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.007
Available formats
×