Infectious Diseases Ward, Nossa Senhora da Glória State Children's Hospital (Serviço de Infectologia do Hospital Estadual Infantil Nossa Senhora da Glória - SI-HEINSG), Vitória-Espírito Santo (ES), Brazil ; Post-Graduate Program in Infectious Diseases, Federal University of Espírito Santo (Universidade Federal do Espírito Santo - UFES). Vitória-Espírito Santo (ES), Brazil.
PLoS One. 2013 Dec 4;8(12):e82027. doi: 10.1371/journal.pone.0082027. eCollection 2013.
Studying diseases associated with AIDS is essential for establishing intervention strategies because comorbidities can lead to death. The objectives were to describe the frequency of comorbidities and verify their distribution according to demographic, epidemiological and clinical data as well as to classify diseases in children and adolescents with AIDS in Vitória, Brazil.
A retrospective cohort study was conducted among children with AIDS, as defined according to the criteria established by the Ministry of Health, who acquired HIV via vertical transmission, were aged 0 to 18 years, and were monitored at a referral hospital from January 2001 to December 2011.
A total of 177 patients were included, of whom 97 were female (55%). There were 60 patients (34%) <1 year old, 67 patients (38%) between the ages of 1 and 5, and 50 patients (28%) ≥6 years of age included at the time of admission to the Infectious Diseases Ward. Regarding clinical-immunological classification, 146 patients (82.5%) showed moderate/severe forms of the disease at the time of admission into the Ward, and 26 patients (14.7%) died during the study. The most common clinical signs were hepatomegaly (81.62%), splenomegaly (63.8%), lymphadenopathy (68.4%) and persistent fever (32.8%). The most common comorbidities were anaemia (67.2%), pneumonia/septicaemia/acute bacterial meningitis (ABM) (64.2%), acute otitis media (AOM)/recurrent sinusitis (55.4%), recurrent severe bacterial infections (47.4%) and dermatitis (43.1%). An association between severe clinical-immunological classification and admission to the Ward for children aged less than one year old was found for several comorbidities (p<0.001).
Delayed diagnosis was observed because the majority of patients were admitted to the Infectious Diseases Ward at ≥1 year of age and were already presenting with serious diseases. The general paediatrician should be alert to this possibility to make an early diagnosis in children infected with HIV.
研究与艾滋病相关的疾病对于制定干预策略至关重要，因为合并症可能导致死亡。本研究的目的是描述合并症的频率，并根据人口统计学、流行病学和临床数据验证其分布情况，同时对巴西维多利亚州艾滋病儿童和青少年的疾病进行分类。
这是一项回顾性队列研究，研究对象为通过垂直传播感染 HIV 的、0 至 18 岁的艾滋病儿童，他们在 2001 年 1 月至 2011 年 12 月期间在一家转诊医院接受监测。
共纳入 177 名患者，其中女性 97 名（55%）。60 名患者（34%）<1 岁，67 名患者（38%）1 至 5 岁，50 名患者（28%）≥6 岁，在进入传染病病房时被纳入研究。根据临床-免疫分类，146 名患者（82.5%）在进入病房时表现为中重度疾病，26 名患者（14.7%）在研究期间死亡。最常见的临床体征是肝肿大（81.62%）、脾肿大（63.8%）、淋巴结病（68.4%）和持续性发热（32.8%）。最常见的合并症是贫血（67.2%）、肺炎/败血症/急性细菌性脑膜炎（ABM）（64.2%）、急性中耳炎/复发性鼻窦炎（55.4%）、复发性严重细菌感染（47.4%）和皮炎（43.1%）。发现严重的临床-免疫分类与<1 岁儿童入院之间存在几种合并症的关联（p<0.001）。
大多数患者在≥1 岁时才进入传染病病房，且已经患有严重疾病，因此观察到诊断延迟。普通儿科医生应该对此保持警惕，以便对感染 HIV 的儿童进行早期诊断。
