Pol Ramesh R, Shepur T A, Ratageri Vinod H
Department of Pediatrics, Karnataka Institute of Medical Science, Hubli, Karnataka, India.
Indian J Pediatr. 2007 Dec;74(12):1071-5. doi: 10.1007/s12098-007-0199-3.
To study the clinical manifestations and incidence of opportunistic infections in HIV/AIDS seropositive proven hospitalized children.
Proven HIV seropositive children aged between 18 months to 12 years, admitted between April 2004 to June 2005 (15 months) to pediatric medical ward, KIMS, Hubli, were enrolled. Socio-demographic characteristics and clinical manifestations were recorded in the predesigned proforma. A complete physical examination and laboratory investigations were performed at the time of admission. Children were categorized as per 1994 revised CDC classification of pediatric HIV infection.
Number of HIV seropositive children admitted during study period was 71. Vertical transmission was noted in 94.37%, which is the major route of transmission. The common symptoms noted were persistent fever (70.42%), persistent cough (59.15%), loss of appetite (59.15%), loss of weight (56.33%) and recurrent diarrhea (30.99%). The common signs present were, hepatomegaly (69.04%), skin lesions (59.15%), lymphadenopathy (57.75%) and severe malnutrition (54.93%). The common opportunistic infections observed were tuberculosis (38.03%), recurrent diarrhea (30.99%), oral candidiasis (21.13%) and recurrent bacterial pneumonia (12.68%). Six (8.45%) children died during the study period, which included 4 (5.63%) cases of HIV-encephalopathy.
Vertical transmission was the major route of HIV infection. Persistent fever, cough, loss of appetite and loss of weight were common presenting clinical features. Tuberculosis was the commonest opportunistic infection.
研究经证实住院的HIV/AIDS血清学阳性儿童的临床表现及机会性感染发生率。
选取2004年4月至2005年6月(15个月)期间入住胡布利KIMS儿科病房的18个月至12岁经证实HIV血清学阳性儿童。社会人口学特征和临床表现记录在预先设计的表格中。入院时进行全面体格检查和实验室检查。根据1994年修订的美国疾病控制与预防中心(CDC)儿科HIV感染分类对儿童进行分类。
研究期间入院的HIV血清学阳性儿童有71例。94.37%为垂直传播,这是主要传播途径。常见症状有持续发热(70.42%)、持续咳嗽(59.15%)、食欲不振(59.15%)、体重减轻(56.33%)和反复腹泻(30.99%)。常见体征有肝肿大(69.04%)、皮肤病变(59.15%)、淋巴结病(57.75%)和重度营养不良(54.93%)。观察到的常见机会性感染有结核病(38.03%)、反复腹泻(30.99%)、口腔念珠菌病(21.13%)和反复细菌性肺炎(12.68%)。研究期间有6例(8.45%)儿童死亡,其中包括4例(5.63%)HIV脑病病例。
垂直传播是HIV感染的主要途径。持续发热、咳嗽、食欲不振和体重减轻是常见的临床表现。结核病是最常见的机会性感染。