Madhivanan Purnima, Mothi S N, Kumarasamy N, Yepthomi T, Venkatesan C, Lambert John S, Solomon Suniti
YR Gaitonde Centerfor AIDS Research and Education, Chennai, Tamil Nadu, India.
Indian J Pediatr. 2003 Aug;70(8):615-20. doi: 10.1007/BF02724249.
Heterosexual contact is the predominant mode of transmission among adults in India with an increasing number of women of childbearing age becoming infected with HIV. Consequently, children in India increasingly getting infected, primarily from vertical transmission. A retrospective review of the profile of HIV infected children attending an HIV clinic in South India is reported.
All HIV-infected children under 15 years of age at the time of first presentation and managed at this center between June 1996 and June 2000 are included in this report. Socio-demographic characteristics and clinical manifestation were collected in a precoded proforme. A complete physical examination and baseline laboratory investigations were performed at entry into the clinic and at subsequent follow-up.
Fifty-eight HIV-infected children were included: thirty-nine (67.2%) were male with mean age 4 years. Perinatal transmission was the predominant mode of HIV acquisition (67%). Common clinical manifestations in these children at presentation included oral candidiasis (43%), pulmonary tuberculosis (35%), recurrent respiratory infections (26%), bacterial skin infection (21%), papulo-pruritic dermatitis (19%), hepatosplenomegaly and lymphadenopathy (14%) each and chronic diarrhea (7%).
An understanding of the epidemiology of pediatric HIV infection may reveal opportunities to reduce and perhaps eliminate perinatal transmission. Knowledge of clinical manifestations in this setting will help physicians meet the management challenges presented by HIV infected children.
在印度，异性接触是成年人中主要的传播方式，越来越多的育龄妇女感染了艾滋病毒。因此，印度的儿童感染艾滋病毒的情况日益增多，主要是通过垂直传播。本文报告了对印度南部一家艾滋病毒诊所中艾滋病毒感染儿童情况的回顾性研究。
本报告纳入了1996年6月至2000年6月期间首次就诊时年龄在15岁以下且在该中心接受治疗的所有艾滋病毒感染儿童。通过预先编码的表格收集社会人口学特征和临床表现。在进入诊所时及随后的随访中进行全面的体格检查和基线实验室检查。
共纳入58名艾滋病毒感染儿童：39名（67.2%）为男性，平均年龄4岁。围产期传播是艾滋病毒感染的主要方式（67%）。这些儿童就诊时的常见临床表现包括口腔念珠菌病（43%）、肺结核（35%）、反复呼吸道感染（26%）、细菌性皮肤感染（21%）、丘疹性瘙痒性皮炎（19%）、肝脾肿大和淋巴结病（各14%）以及慢性腹泻（7%）。
了解儿童艾滋病毒感染的流行病学情况可能会发现减少甚至消除围产期传播的机会。了解这种情况下的临床表现将有助于医生应对艾滋病毒感染儿童带来的管理挑战。
