A four-year cohort study of HIV seropositive Ethiopian infants and children: clinical course and disease patterns.

Sixty-two HIV positive infants who were admitted to the Missionaries of Charity Orphanage in Addis Ababa were followed From July 25, 1991 to July 30, 1995 for a total period of 4 years. Regular clinical examination and treatment by a paediatrician was being offered to these infants in addition to monitoring of their HIV serostatus every three months until the age of 18 months and every year after that. Among those aged above 18 months, 14 children were HIV sero-positive and alive and 4 children were HIV sero-positive but died. Thirty-three children had sero-reverted to negative. The mother-to-child transmission was crudely estimated at 29% to 47%. Among the clinical signs, generalized lymphadenopathy, hepatomegaly, splenomegaly, wasting, stunting and delayed motor development were found more commonly in the definitely HIV positive children. Upper respiratory tract infections, acute diarrhoea, pneumonia, pyogenic skin infections, sepsis and candidal infections were the commonest causes of illness. Comparison of the HIV positive with the HIV negative cases indicates that the risk is higher for the indefinitely HIV positive group for episodes of acute diarrhoea, pneumonia, sepsis and candidal infections.