Excler J L, Standaert B, Ngendandumwe E, Piot P
Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi.
Pediatrie. 1987;42(9):715-8.
HIV infection was present in 18 out of 40 (45%) consecutive malnourished children aged 2 to 29 months in pediatric wards of Bujumbura, Burundi. No difference was observed within and between the seropositive and seronegative groups for sex and anthropometric measures. HIV seropositive cases could be explained by a HIV seropositive mother (83%) or by a transfusion history (17%). The onset of marasmus was earlier in the HIV seropositive group (5 cases observed less than 6 months old compared to none of the other group, Fischer's exact test: P = 0.026). A more complex clinical picture was seen in the HIV seropositive cases (12/18 compared to 4/22, Fischer's exact test: P = 0.004) with the presence of hepatomegaly, adenopathy, thrush, dyspnoea and skin disorders. No difference was observed concerning fever and diarrhoea. HIV seropositive group tended to show a higher hospitalisation frequency and did not well respond to high protein-energy diet: 7 were discharged without gain weight compared to none of the other group (Fischer's exact test: P = 0.011). These results suggest a high rate of vertical transmission mother-child for HIV infection and a frequent association of malnutrition and HIV infection in hospitalized children in Burundi. Marasmic children less than 6 months old should be highly suspected of HIV infection.
在布隆迪布琼布拉儿科病房连续收治的40名年龄在2至29个月的营养不良儿童中，有18名（45%）感染了艾滋病毒。在血清阳性和血清阴性组内及组间，性别和人体测量指标均未观察到差异。艾滋病毒血清阳性病例的感染原因可能是母亲血清阳性（83%）或有输血史（17%）。消瘦型营养不良在艾滋病毒血清阳性组发病更早（观察到5例小于6个月大，而另一组无此情况，费舍尔精确检验：P = 0.026）。艾滋病毒血清阳性病例的临床症状更为复杂（12/18，而另一组为4/22，费舍尔精确检验：P = 0.004），表现为肝肿大、淋巴结病、鹅口疮、呼吸困难和皮肤疾病。在发热和腹泻方面未观察到差异。艾滋病毒血清阳性组的住院频率往往较高，对高蛋白能量饮食反应不佳：7例出院时体重未增加，而另一组无此情况（费舍尔精确检验：P = 0.011）。这些结果表明，在布隆迪住院儿童中，艾滋病毒母婴垂直传播率很高，且营养不良与艾滋病毒感染经常并存。6个月以下的消瘦型营养不良儿童应高度怀疑感染艾滋病毒。
