HIV 暴露但未感染儿童的手术结果。
Outcome of HIV-exposed uninfected children undergoing surgery.
机构信息
Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, South Africa.
出版信息
BMC Pediatr. 2011 Jul 29;11:69. doi: 10.1186/1471-2431-11-69.
BACKGROUND
HIV-exposed uninfected (HIVe) children are a rapidly growing population that may be at an increased risk of illness compared to HIV-unexposed children (HIVn). The aim of this study was to investigate the morbidity and mortality of HIVe compared to both HIVn and HIV-infected (HIVi) children after a general surgical procedure.
METHODS
A prospective study of children less than 60 months of age undergoing general surgery at a paediatric referral hospital from July 2004 to July 2008 inclusive. Children underwent age-definitive HIV testing and were followed up post operatively for the development of complications, length of stay and mortality.
RESULTS
Three hundred and eighty children were enrolled; 4 died and 11 were lost to follow up prior to HIV testing, thus 365 children were included. Of these, 38(10.4%) were HIVe, 245(67.1%) were HIVn and 82(22.5%) were HIVi children.The overall mortality was low, with 2(5.2%) deaths in the HIVe group, 0 in the HIVn group and 6(7.3%) in the HIVi group (p = 0.0003). HIVe had a longer stay than HIVn children (3 (2-7) vs. 2 (1-4) days p = 0.02). There was no significant difference in length of stay between the HIVe and HIVi groups. HIVe children had a higher rate of complications compared to HIVn children, (9 (23.7%) vs. 14(5.7%) (RR 3.8(2.1-7) p < 0.0001) but a similar rate of complications compared to HIVi children 34 (41.5%) (RR = 0.6 (0.3-1.1) p = 0.06).
CONCLUSION
HIVe children have a higher risk of developing complications and mortality after surgery compared to HIVn children. However, the risk of complications is lower than that of HIVi children.
背景
与未感染 HIV 的儿童（HIVn）相比，HIV 暴露未感染（HIVe）的儿童是一个快速增长的群体，他们可能面临更高的患病风险。本研究旨在调查 HIVe 儿童在接受普通外科手术后与 HIVn 和 HIV 感染（HIVi）儿童相比的发病率和死亡率。
方法
对 2004 年 7 月至 2008 年 7 月期间在一家儿科转诊医院接受普通外科手术的小于 60 个月龄的儿童进行前瞻性研究。儿童接受年龄确定的 HIV 检测，并在手术后进行随访，以了解并发症的发生、住院时间和死亡率。
结果
共纳入 380 名儿童；4 名儿童死亡，11 名儿童在 HIV 检测前失访，因此共纳入 365 名儿童。其中，38 名（10.4%）为 HIVe，245 名（67.1%）为 HIVn，82 名（22.5%）为 HIVi 儿童。总体死亡率较低，HIVe 组有 2 例（5.2%）死亡，HIVn 组无死亡，HIVi 组有 6 例（7.3%）死亡（p=0.0003）。HIVe 儿童的住院时间长于 HIVn 儿童（3（2-7）vs. 2（1-4）天，p=0.02）。HIVe 与 HIVi 组之间的住院时间无显著差异。与 HIVn 儿童相比，HIVe 儿童的并发症发生率更高（9 例[23.7%]vs. 14 例[5.7%]（RR 3.8[2.1-7]，p<0.0001），但与 HIVi 儿童的并发症发生率相似（34 例[41.5%]）（RR=0.6[0.3-1.1]，p=0.06）。
结论
与 HIVn 儿童相比，HIVe 儿童在手术后发生并发症和死亡的风险更高。然而，与 HIVi 儿童相比，HIVe 儿童的并发症风险较低。
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