Merchant R H, Oswal J S, Bhagwat R V, Karkare J
Bai Jerbai Wadia Hospital for Children, Acharya Dhonde Marg, Parel, Mumbai 400 012, India.
Indian Pediatr. 2001 Mar;38(3):239-46.
To study the clinical profile of human immunodeficiency virus (HIV) infection in children.
Prospective.
HIV clinic at a pediatric tertiary care center in an urban metropolis.
From August 1994 onwards, 285 HIV positive children were referred to the HIV clinic. These included those intramural deliveries born to HIV positive mothers, those referred from other centers with a positive HIV ELISA (enzyme-linked immunosorbent assay) test and those screened routinely at our center in view of transfusion dependence and found to be HIV positive. After informed consent from either parent, the HIV status of all referred patients was retested by ELISA.
Two hundred and thirteen (74.73%) patients were below the age of five years. Vertical transmission as the route of infection was documented in 247 (86.66%), 33 (11.57%) were infected through blood and in 5 (1.75%), the mode of transmission could not be ascertained. The clinical features noted were protein energy malnutrition in 127 (44.56%), pulmonary and extrapulmonary tuberculosis in 84 (29.47%), hepatosplenomegaly in 82 (28.77%), persistent generalized lymphadenopathy in 67 (23.50%), skin lesions in 63 (22.10%), chronic diarrhea in 43 (15.08%), oral thrush in 42 (14.73%), pyrexia of unknown origin in 36 (12.63%), chronic lung disease in 32 (11.22%), chronic hypertrophic parotitis in 27 (9.47%), chronic ottorrhea in 26 (9.12%), recurrent lower respiratory tract infection in 24 (8.42%), neurological manifestations of non-tuberculous origin in 13 (4.56%) and Pneumocystis carinii pneumonia in 11(3.88%). Forty-eight (16.84%) were asymptomatic, 30 (10.52%) died of AIDS during the study period and 39 (13.68%) have been lost to follow up.
Vertical transmission was the commonest mode of infection. Perinatally infected children become symptomatic by five years of age. Protein energy malnutrition, hepatosplenomegaly and persistent generalized lymphadenopathy were common presenting features. Tuberculosis was the major co-infection. Chronic hypertrophic parotitis and chronic lung disease were distinguishing features of this study. Encephalopathy was associated with poor outcome.
研究儿童人类免疫缺陷病毒（HIV）感染的临床特征。
前瞻性研究。
大都市一家儿科三级护理中心的HIV诊所。
从1994年8月起，285名HIV阳性儿童被转诊至该HIV诊所。这些儿童包括HIV阳性母亲的院内分娩儿、其他中心转诊来的HIV酶联免疫吸附测定（ELISA）检测呈阳性的儿童，以及因输血依赖在本中心进行常规筛查而被发现HIV阳性的儿童。在获得父母任何一方的知情同意后，所有转诊患者的HIV状况通过ELISA重新检测。
213名（74.73%）患者年龄在5岁以下。记录显示，247名（86.66%）通过垂直传播感染，33名（11.57%）通过血液感染，5名（1.75%）传播途径无法确定。观察到的临床特征包括：127名（44.56%）蛋白质能量营养不良，84名（29.47%）肺和肺外结核，82名（28.77%）肝脾肿大，67名（23.50%）持续性全身淋巴结肿大，63名（22.10%）皮肤病变，43名（15.08%）慢性腹泻，42名（14.73%）口腔念珠菌病，36名（12.63%）不明原因发热，32名（11.22%）慢性肺病，27名（9.47%）慢性肥厚性腮腺炎，26名（9.12%）慢性耳漏，24名（8.42%）反复下呼吸道感染，13名（4.56%）非结核性神经表现，11名（3.88%）卡氏肺孢子虫肺炎。48名（16.84%）无症状，30名（10.52%）在研究期间死于艾滋病，39名（13.68%）失访。
垂直传播是最常见的感染方式。围产期感染的儿童在5岁前出现症状。蛋白质能量营养不良、肝脾肿大和持续性全身淋巴结肿大是常见的临床表现。结核病是主要的合并感染。慢性肥厚性腮腺炎和慢性肺病是本研究的显著特征。脑病与不良预后相关。
