DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172608

A study on clinical profile of paediatric HIV infection in the age group of 18 months to 12 years and its correlation with CD4 count

Sureshkumar Ramaswamy, Murali Thandavarayan, Sivaraman Thirumalaikumarasamy, Aparna Sureshkumar

Abstract


Background: The aim of the study was to assess the clinical profile of pediatric HIV infection in the age group of 18 month to 12 years and to correlate the clinical features with their CD4 count.

Methods: This descriptive study was conducted over a period of 1 year from October 2007 to October 2008 at Govt. Mohan Kumaramangalam Medical College Hospital, Salem and included 100 children (aged between 18 months-12 years) diagnosed HIV by using rapid antigen tests or ELISA. Demographic data, clinical manifestations correlating with CD4 count and nutritional status of the children were recorded in predesigned proforma and analysed.

Results: 100 children were included (males-65 and females-35) in the study. 22 children were asymptomatic and 78 were symptomatic. Clinical symptoms like skin lesions in 29, oral lesions in 10, lymphadenopathy in 46 children were observed. The respiratory (13%), central nervous (12%) and haemotological systems (16%) were most commonly involved organs systems. Children in stage III and IV disease were into Grade I-IV PEM classification (for weight) and majority of stage I-IV children were in Grade II according to Mclaren’s classification (for height).

Conclusions: Majority of children with HIV infection presented with various clinical manifestations, malnutrition and immunosuppression. Hence, early identification of the disease and proper management in children helps in improving the immunological status and thereby life span of the child. 


Keywords


CD4 count, HIV infection, Pediatrics

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References


Joint United Nations program on HIV/AIDS (UNAIDS)/WHO. AIDS epidemic update. 2006. Available at URL:http://www.unaids.org/en/ Publications/default.asp. Accessed on 1 October 2007.

Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO). AIDS epidemic update: December 2003. UNAIDS, WHO. 2003.

Elmer K, Elston DM. Childhood HIV disease. http://www.emedicine. com/derm/topic760.htm. Accessed on 23 November 2003.

Lindegren ML, Steinberg S, Byers RH Jr. Epidemiology of HIV/AIDS in children. Pediatr Clin North Am. 2000;47:1-20.

Sentinel surveillance report by NACO 2006-2007. Available at naco.gov.in/sites/default/files/HIV_Sentinel_Surveillance_report.pdf. Accessed on 21st December 2016.

Barnhart HX, Caldwell MB, Thomas P. Natural history of human immunodeficiency virus disease in perinatally infected children: An analysis from the Pediatric Spectrum of Disease Project. Pediatrics. 1996;97:710-6.

Lodha R, Singhal T, Kabra SK. Pediatric HIV infection: clinical manifestation and diagnosis. Ann Natl Acad Mcd Sci (India). 2000;36:75-82.

Shah SR, Tullu MS, Kamat JR. Clinical Profile of Pediatric HIV Infection from India. Arch Med Res. 2005;36:24-31.

Dhurat R, Manglani M, Sharma R, Shah NK. Clinical spectrum of HIV infection. Indian Pediatr. 2000;37:831-6.

Chakravarty J, Mehta H, Parekh A, Attili SV, Agarwal NR, Singh SP, et al. Study on clinico epidemiological profile of HIV patients in eastern India. J Assoc Physicians India. 2006;54:854-7.

Ylitalo N, Brogly S, Hughes MD, Nachman S, Dankner W, Van Dyke R, et al. Risk factors for opportunistic illnesses in children with human immunodeficiency virus in the era of highly active antiretroviral therapy. Arch Pediatr Adolesc Med. 2006;160:778-87.

Merchant RH, Oswal JS, Bhagwat RV, Karkare J. Clinical profile of HIV infection. Indian Pediatr. 2001;38:238-46.

Abuzaitoun OR, Hanson IC. Organ-specific manifestations of HIV disease in children. Pediatr Clin North Am. 2000;47:109-25.

Udgirkar VS, Tullu MS, Bavdekar SB, Shaharao VB, Kamat JR, Hira PR. Neurological manifestations of HIV infection. Indian Pediatr. 2003;40:230-4.

Madhivanan P, Mothi SN, Kumarasamy N, Yepthomi T, Venkatesan C, Lambert JS, et al. Clinical manifestations of HIV infected children. Indian J Pediatr. 2003:70:615-20.

Fox- Wheeler S, Heller L, Salata CM, Kaufman F, Loro LM, Gilsang V, et al. Evaluation of the effects of oxandrolone on malnourished HIV-positive pediatric patients. Pediatrics. 1999;104:1-7.

Shah I. Correlation of CD4 count, CD4% and HIV viral load with clinical manifestations of HIV infected Indian children. Ann Trop Pediatr. 2006;26:115-9.

Bachou H, Tylleskar T, Downing R, Tumwine JK. Severe malnutrition with and without HIV-1 infection in hospitalized children in Kampala, Uganda, differences in clinical features, hematological findings and CD4+ cell counts. Nutr J. 2006;5:27-32.