Okechukwu A A, Gambo D, Okechukwu O I
Department of Paediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Niger J Med. 2008 Oct-Dec;17(4):433-8. doi: 10.4314/njm.v17i4.37428.
The reported geographical differences in the HIV-1 sub-type across the continent and the entire world makes it necessary to investigate whether the clinical presentation and outcome of such presentation can demonstrate differences in the multiple sub- type of HIV-1 infection. To determine whether the clinical presentations and outcome of HIV/AIDS in children in Abuja, Nigeria conforms with reports from elsewhere both within and outside the country.
A one-year prospective study of HIV infected children attending the University of Abuja Teaching Hospital (UATH), Gwagwalada, from November 2006 to October 2007, was carried out to determine the clinical presentation and outcome of such presentation in the area.
A total of 173 patients were diagnosed with signs and symptoms of HIV/AIDS and on antiretroviral therapy (ARVT). There were 90 (52.0%) males and 83 (48.0%) females giving a male to female ratio of 1.1:1. Less than 5 years constituted 81.5% of paediatric patients seen, with less than 2 years responsible for 52.0% of cases, and 11.8% being those between the ages of 10-15 years. The commonest presenting complains were that of recurrent fever (80.3%), progressive weight loss (77.5%), and persistent diarrhoea (69.1%). Chronic cough (62.2%) and skin rashes (52.7%) were equally common. While persistent diarrhoea, oral thrush, discharging ear, and failure to thrive were commoner in children less than two years, generalised lymphadenopathy skin rashes and parotid swelling were commoner in older children. Mortality rate was found to be 3.5%, while WHO case definition for paediatric HIV/AIDS in African setting was found to be sensitive with low specificity and positive predictive value (PPV).
Clinical presentation of paediatric HIV/AIDS appears similar with reports from other centers in spite of the wide variation in HIV-1 sub-types. Mortality was also found to be low. This was attributed largely to the availability of free antiretroviral drugs (ARVD), potent antibiotics and anti-fungal agents which were made freely available to HIV infected patients. The findings underscore the need for government to extend such services to HIV/AIDS patients across the country as a major way of reducing the sufferings of this scourge in children.
据报道，整个非洲大陆乃至全世界的HIV-1亚型存在地理差异，因此有必要调查HIV-1感染多种亚型的临床表现及此类表现的结果是否存在差异。以确定尼日利亚阿布贾儿童HIV/AIDS的临床表现及结果是否与该国国内及国外其他地方的报告相符。
2006年11月至2007年10月，对在瓜瓜瓦拉达阿布贾大学教学医院（UATH）就诊的HIV感染儿童进行了为期一年的前瞻性研究，以确定该地区此类疾病的临床表现及结果。
共有173例患者被诊断出患有HIV/AIDS体征和症状并接受抗逆转录病毒治疗（ARVT）。其中男性90例（52.0%），女性83例（48.0%），男女比例为1.1:1。5岁以下儿童占就诊儿科患者的81.5%，其中2岁以下儿童占病例的52.0%，10至15岁儿童占11.8%。最常见的主诉是反复发热（80.3%）、进行性体重减轻（77.5%）和持续性腹泻（69.1%）。慢性咳嗽（62.2%）和皮疹（52.7%）同样常见。持续性腹泻、鹅口疮、耳部流脓和发育不良在2岁以下儿童中更为常见，而全身淋巴结肿大、皮疹和腮腺肿大在年龄较大的儿童中更为常见。死亡率为3.5%，而WHO在非洲环境下的儿科HIV/AIDS病例定义被发现敏感性高，但特异性和阳性预测值（PPV）较低。
尽管HIV-1亚型差异很大，但儿科HIV/AIDS的临床表现似乎与其他中心的报告相似。死亡率也较低。这主要归因于免费抗逆转录病毒药物（ARVD）、强效抗生素和抗真菌药物的可获得性，这些药物免费提供给HIV感染患者。研究结果强调政府有必要将此类服务扩展到全国的HIV/AIDS患者，这是减轻儿童这一祸害痛苦的主要途径。
