Age and CD4 count of vertically HIV-infected children at the time of diagnosis: what are independent predictors for being symptomatic and CD4 counts drop?

A review of the literature has revealed that data on HIV-infected clinical presentations, age at the time of diagnosis and level of immunosuppression in resource-poor settings are very limited. A multicenter retrospective and cross-sectional method was used to analyze 1163 children <15 years of age. More than half of the children were >5 years of age (mean ± SD age 4.9 ± 3.2). About 54% of children were symptomatic. Tuberculosis and chronic dermatologic disorders were the commonest co-infections. The severity of immunosuppression was highest in preschool children (46.6%) and early adolescents (41.3%). After adjustment for sex, age, pattern of feeding and hemoglobin level, multinomial logistic regression showed that CD4 count 200-499, 500-999 and Tigray ethnicity were independently associated with being symptomatic. More than one-third of the children were in a state of severe immunosuppression and more than half were immunologically eligible for antiretroviral treatment.