Pediatric Infectious Diseases Clinic Research Articles

Assessment of 35 children with abdominal tuberculosis.

To contribute to the diagnosis and treatment of pediatric abdominal tuberculosis cases by assessing the clinical, laboratory, and radiological features of patients who presented at our clinic and were diagnosed with abdominal tuberculosis. Clinical, laboratory, and radiological features were reviewed retrospectively for 35 patients diagnosed with abdominal tuberculosis and followed up at the Pediatric Infectious Diseases Clinic between January 1987 and August 2012. The study group included 16 female (45.7%) and 19 male (54.3%) patients with an age range of 6 months to 16 years (mean: 9.77±4.36 years). Twenty-nine patients were diagnosed with tuberculosis peritonitis, five patients with intestinal tuberculosis, and one patient with pelvic tuberculosis. The most common signs and symptoms were ascites, abdominal pain, abdominal distention, weight loss, and fever. Mean duration of the complaints was 109 days (range: 10 days to 3 years). Abdominal tuberculosis is a disease with an insidious course without disease-specific clinical and laboratory signs. When the disease is suspected, laparoscopy or laparotomy could be helpful in diagnosis. Employing ultrasound and computed tomography signs, abdominal tuberculosis should be included in differential diagnoses in regions with a high incidence of tuberculosis when there is abdominal pain, weight loss, ascites, history of contact with individuals with tuberculosis, and positive tuberculin skin test when patients have not been Bacillus Calmette Guerin BCG vaccinated.

Characteristics of Patients Referred to a Pediatric Infectious Diseases Clinic With Unexplained Fever.

Older case series established diagnostic considerations for children meeting a priori definitions of fever of unknown origin (FUO). No recent study has examined the final diagnoses of children referred for unexplained fever. This study was conducted with a retrospective chart review of patients referred to a pediatric infectious diseases clinic from 2008 to 2012 for unexplained fever. Sixty-nine of 221 patients were referred for "prolonged" unexplained fever. Ten of these were not actually having fever, and 11 had diagnoses that were readily apparent at the initial visit. The remaining 48 were classified as having FUO. The median duration of reported fever for these patients was 30 days; 15 had a diagnosis made, 5 of which were serious. None of the serious FUO diagnoses were infections. Of 152 patients with "recurrent" unexplained fever, 92 had an "intermittent" fever pattern, and most of these had sequential, self-limited viral illnesses or no definitive diagnosis made. Twenty of the 60 patients with a "periodic" fever pattern were diagnosed with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome. Overall, 166 patients either were not having fever, had self-limited illnesses, or ultimately had no cause of fever discovered. Only 12 had a serious illness, 2 of which were infections (malaria and typhoid fever). Most children referred with unexplained fever had either self-limited illnesses or no specific diagnosis established. Serious diagnoses were unusual, suggesting that these diagnoses rarely present with unexplained fever alone, or that, when they do, the diagnoses are made by primary care providers or other subspecialists.

Periorbital ve Orbital Selülit: Başvurudan Sonuçlara

Objective: Orbital infections require prompt diagnosis and treatment because of the risk of severe complications. Although preseptal cellulitis and orbital cellulitis are different clinical conditions, they can often be confused or can be seen concomitantly. In this study, we aimed to evaluate all patients diagnosed with these diseases treated in our clinic in order to analyze clinical findings, preferred imaging modalities, treatment choices, and clinical outcomes. Material and Methods: This retrospective study was performed between January 1999 and January 2013. We evaluated patients who were admitted to the Ankara University Pediatric Infectious Disease Clinic with a diagnosis of preseptal or orbital cellulitis. Clinical and laboratory characteristics of the patients were compared. Significance level was determined as α=0.05. Results: A total of 71 patients (34 girls, 37 boys) with a diagnosis of preseptal (50 patients) or orbital cellulitis (21 patients) were included into the study. The mean age at diagnosis was 49±37.4 (2-168) months. Waters graphy and/or orbital computed tomography was performed in 27 (54%) patients with preseptal cellulitis and in 18 (85%) patients with orbital cellulitis. Almost all of the patients responded to medical therapy without sequelae, and only 3 of them required surgical treatment additionally. The patients with preseptal and orbital cellulitis were treated successfully with sulbactam-ampicillin (150 mg/kg/day and 200 mg/kg/day, respectively). Conclusion: We conclude that these infections can be treated without any morbidity and mortality if it is diagnosed early and suitable antibiotic treatment is promptly instituted. Imaging tools can give us detailed information regarding disease involvement, differential diagnosis, and the need for surgical intervention. However, we think that these imaging modalities, such as computed tomography, should be restricted as much as possible because of high-dose radiation exposure risk. (J Pediatr Inf 2014; 8: 148-52)

1421Characteristics of Patients Referred to a Pediatric Infectious Diseases Clinic with Unexplained Fever

1421Characteristics of Patients Referred to a Pediatric Infectious Diseases Clinic with Unexplained Fever

WS11.3 Change of algorithm in the CF centers influences the amount of equivocal CF diagnoses in the newborn screening program in Switzerland

I. Valaskova1,2,3, J. Necasova1, R.M. Selingerova1, R. Spesna1, A. Holcikova4, L. Homola4, E. Pokojova5, R. Gaillyova1,2,3. 1University Hospital, Medical Genetics, Brno, Czech Republic; 2Masaryk University, Faculty of Medicine, Department of Biology, Brno, Czech Republic; 3Masaryk University, Faculty of Medicine, Department of Laboratory Methods, Brno, Czech Republic; 4University Hospital, Clinic of Pediatric Infectious Diseases, Brno, Czech Republic; 5University Hospital, Department of Pulmonary Diseases and Tuberculosis, Brno, Czech Republic

WS11.1 Development of a comprehensive workflow for the analysis of CFTR gene using next generation sequencing technology

I. Valaskova1,2,3, J. Necasova1, R.M. Selingerova1, R. Spesna1, A. Holcikova4, L. Homola4, E. Pokojova5, R. Gaillyova1,2,3. 1University Hospital, Medical Genetics, Brno, Czech Republic; 2Masaryk University, Faculty of Medicine, Department of Biology, Brno, Czech Republic; 3Masaryk University, Faculty of Medicine, Department of Laboratory Methods, Brno, Czech Republic; 4University Hospital, Clinic of Pediatric Infectious Diseases, Brno, Czech Republic; 5University Hospital, Department of Pulmonary Diseases and Tuberculosis, Brno, Czech Republic

WS11.2 Age related cut-off levels for immunoreactive trypsin (IRT) in healthy newborns in the first two months of life

I. Valaskova1,2,3, J. Necasova1, R.M. Selingerova1, R. Spesna1, A. Holcikova4, L. Homola4, E. Pokojova5, R. Gaillyova1,2,3. 1University Hospital, Medical Genetics, Brno, Czech Republic; 2Masaryk University, Faculty of Medicine, Department of Biology, Brno, Czech Republic; 3Masaryk University, Faculty of Medicine, Department of Laboratory Methods, Brno, Czech Republic; 4University Hospital, Clinic of Pediatric Infectious Diseases, Brno, Czech Republic; 5University Hospital, Department of Pulmonary Diseases and Tuberculosis, Brno, Czech Republic

Persistent Microalbuminuria in Human Immunodeficiency Virus Infected Children in Kano, Nigeria

Microalbuminuria has been reported to be a precursor of HIV related renal disease, which if detected early and coupled with appropriate intervention may slow or retard the progress of the disease. One hundred and seventy-eight HIV infected children aged 15 years and below were recruited from the Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital (AKTH), Kano, to determine the prevalence of persistent microalbuminuria using the albumin creatinine ratio (ACR). Early morning urine samples and spot urine samples were analyzed using a dipstick specific for microalbumin. Those who tested positive had their samples reanalyzed in the laboratory using immunometric assay and Jaffe reaction method for albumin and creatinine, respectively. Patients that had ACR of 30–300 mg/g were said to have microalbuminuria and had their urine samples retested after 6 to 8 weeks. Twelve children (6.7%) had persistent microalbuminuria and had a mean age of 7.5 ± 3.3 years, with a male to female ratio of 1 : 1. There was no significant relationship between the finding of microalbuminuria and age, sex, duration of infection, and the use of highly active antiretroviral therapy. Periodic screening for microalbuminuria using albumin specific dipstick should be considered for children with HIV infection.

PW03-032 – Periodic fevers in children

This is a retrospective case review of patients presenting with periodic fevers to the paediatric infectious disease clinic at the Children’s Hospital, Oxford, over a ten year period.

A 14-Year-Old Boy With Nodules on His Feet.

A 14-year-old previously healthy boy was referred to the pediatric infectious disease clinic for evaluation of painful nodules, which had been present for 2 weeks, on both soles of his feet. The nodules were first noted 2 weeks after returning to the United States from a 1-month family vacation to visit relatives in his native Guyana, South America. The foot nodules were unimproved after application of topical Neosporin and a 1-week course of oral trimethoprimsulfamethoxazole prescribed by his primary care physician. The nodules were nonpurulent but expressed serosanguinous fluid. Neither he nor other family members had developed skin lesions during the trip itself. The patient denied systemic symptoms, including fever, rash, headache, respiratory, or joint complaints. He had no significant past medical history or drug allergies. The patient denied swimming in fresh or sea water, insect bites, or animal contact, and he denied sexual activity; however, he did walk with sandals in sandy soil. On physical examination, his vital signs were within normal limits. The examination was notable only for nodules to the soles of his feet bilaterally (as shown in Figure 1). He had approximately 20 firm, nodules (1 × 2 cm) on his right foot and 9 discrete (1 × 2 cm) nodules on his left. His physical examination was otherwise unremarkable. After dermatology consultation, an excisional skin biopsy was performed with microscopic examination of the biopsy specimens, which confirmed the visual diagnosis.

Body Composition in Prepubertal, HIV‐Infected Children

The aim of this study was to compare bioelectrical impedance analysis (BIA) equations developed for healthy pediatric populations and for HIV-infected children using dual-energy X-ray absorptiometry (DXA) as the gold standard. A cross-sectional study was carried out with 40 prepubertal, HIV-infected children who regularly attended the Pediatric Infectious Disease Clinic at the Universidade Federal de São Paulo, São Paulo, Brazil. The study was conducted from August to November 2008. Demographic data, clinical parameters, immunological status, and use of antiretroviral therapy were obtained from the patients' medical records. We performed anthropometric parameters and body composition analyses, analyzed body composition by BIA and DXA, and compared the results obtained from BIA through using equations for both healthy and HIV-infected populations. The mean ± SD age of the study population was 9.8 ± 1.2 years. Half of the population were females, and 82.5% of the children were clinically classified as B and C. Total body fat, by both absolute mass and by percentage, exhibited high homogeneity between the results obtained from BIA and DXA. However, there was no concordance in fat-free mass. The equation for healthy children showed good sensitivity and specificity when comparing the percentage of total body fat measured by DXA. BIA provides reliable data on total body fat but not fat-free mass when compared with DXA. The BIA equation developed for healthy pediatric populations can be used to determine total body fat in HIV-infected children.

The prevalence of hearing impairment in the 6 months – 5 years HIV/AIDS-positive patients attending paediatric infectious disease clinic at Mulago Hospital

IntroductionHearing impairment is one form of disability in children living with HIV/AIDS. It greatly interferes with their language development, communication and performance. These are stressful to the children and their caretakers. With increasing availability of free anti-retroviral therapy, children with HIV/AIDS are living much longer. Therefore efforts must be made to reduce the disability resulting from hearing impairment among children living with HIV. ObjectiveThe objective of this study was to determine the prevalence, types and severity of hearing loss in HIV positive pediatric patients between 6 months and 5 years of age attending PIDC, Mulago Hospital Uganda. MethodsThis was a descriptive cross sectional study among 370 HIV/AIDS pediatric patients between 6 months and 5 years of age at PIDC Mulago. In this study, hearing impairment was defined as any auditory brainstem response (ABR) average threshold of over 25 dBnHL at frequencies of 500Hz to 4000Hz. This was done using a VIVOSONIC VIVOLINK ABR machine and a tympanogram was acquired from each ear. Systematic random sampling was carried out to reach individual participants. Proportions were used to estimate prevalence of hearing impairment in this age group. ResultsA total of 370 participants were recruited, with mean age of 38 months and median age of 36 months. The ratio of male to female was 1:1. The majority 172/370 (46.5%) of the participants were of WHO stage III. The prevalence of hearing loss in the 6 months to 5 years HIV/AIDS positive patients was found to be 121/370 (33.0%). The majority 77/121 (64.0%) of the participants had sensorineural hearing loss (SNHL). Of these with SNHL 44% had mild (26–40 dBHL) hearing loss. ConclusionsThe prevalence of hearing among pediatric HIV/AIDS patients between the 6 months and 5 years was found to be high with sensorineural hearing loss being the most prevalent. Therefore HIV/AIDS paediatric patients should have routine screening for hearing impairment. A prospective cohort study should be designed to assess the risk of acquisition of hearing loss in children living with HIV.

“It's Like Losing a Part of My Family”: Transition Expectations of Adolescents Living with Perinatally Acquired HIV and Their Guardians

The increased life expectancy of perinatally HIV-infected adolescents necessitates the transition from pediatric to adult infectious disease care. Significant differences exist between pediatric and adult HIV clinic models, and adequate preparation is critical for successful transition. The expectations of youth on the cusp of this transition and their guardians have not previously been explored. Semistructured interviews were conducted with 40 perinatally infected adolescents (mean age, 17.3 years; 90% African American; 57.5% female; 57.5% in high school) currently receiving care in a pediatric infectious disease clinic in the southeast United States and 17 guardians about their expectations related to the pending transition to adult care. Interviews were transcribed and coded for emergent themes. Many adolescents had difficulty articulating expectations of their transition to an adult clinic, reporting they did not know what to expect. Others looked forward to increased responsibility and control, while some expressed concerns over leaving their current providers and having to establish new relationships. Most guardians viewed the transition to adult care as a tool to facilitate maturity. Several indicated they had not discussed transition with their child and were waiting for their child to initiate a conversation about it. Given the importance providers place on preparing youth for transition, it is surprising that many adolescents had no expectations about this impending change. This indicates a need for improved communication between providers and adolescents to enhance preparation and ultimately transition success. Additionally, guardians play an important role in the transition process and may need support to discuss this process with their child.

Disclosure of diagnosis by parents and caregivers to children infected with HIV: Prevalence associated factors and perceived barriers in Addis Ababa, Ethiopia

Vertical transmission of HIV from infected mothers to children is a common phenomenon. After the introduction of highly active antiretroviral treatment (HAART), most children live longer than before. Recently, HAART has become widely available to children living in sub-Saharan African countries, and this makes disclosure of HIV status an important issue. We conducted a cross-sectional survey involving 172 parents/caregivers of HIV-infected school-age children who had follow-up at the Pediatric Infectious Disease Clinic of the Yekatit 12 Hospital, Addis Ababa. Only 16.3% of HIV-infected schoolchildren knew their diagnosis. The child's age was the main predictor of disclosure (OR: −0.25; 95% CI: −0.35, −0.09; p<0.05). The main reason for nondisclosure was fear of negative emotional consequences for the child. More than half of the parent/caregivers agreed that they need to tell the children their diagnosis, but 86% reported that they needed health care providers to help them at the event. The low rate of disclosure found in this study shows the need for awareness creation and training of health professionals, and this should be supported by appropriate guidelines to be followed by health professionals working in pediatric ART clinics. Caregivers need to be provided with the necessary knowledge and skills on how to look after children who know their HIV status.

Visual Diagnosis: A 7-Month-Old Who Has a Persistent Rash

1. Angel Alberto Herrera Guerra, MD* 2. Russell J. Osguthorpe, MD† 3. Angelica Putnam, MD§ 4. Sheryll L. Vanderhooft, MD‡ 1. *Fellow, Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, UT. 2. †Assistant Professor, Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, UT. 3. §Department of Pediatric Pathology, University of Utah, Salt Lake City, UT. 4. ‡Professor, Department of Dermatology, University of Utah, Salt Lake City, UT. A 7-month-old boy presents to the pediatric infectious diseases clinic with an unusual rash for the past 4 weeks. The rash appeared first on the back of his neck as a reddish-brown raised “spot” (Fig. 1). Over the past month, other reddish-brown macules and papules have appeared on his anterior trunk that later have developed a fine scale, followed in some places by erosions and black eschar formation. These lesions were neither vesicular nor pustular in appearance before eroding. The eschars eventually healed, leaving hypopigmented scars. Figure 1. Reddish-brown raised “spot” on back of thigh similar to the “spot” that first appeared on the back of infant's neck. The infant has been asymptomatic otherwise and has gained weight during this time, maintaining his normal appetite and activity. There is no history of fever or discomfort. Initially, a pediatrician thought the infant had scabies and prescribed permethrin cream, but there was no improvement of the infant's condition. The pediatrician then prescribed two courses of antibiotics (cephalexin and amoxicillin) for a presumed varicella infection complicated by bacterial superinfection. Again, there was no improvement. Because of the continued appearance of new lesions the infant was referred to a pediatric infectious diseases clinic. The infant's past medical history is unremarkable. He was delivered vaginally without complications at term and has been healthy otherwise until the rash appeared. There has been no animal exposure or travel. There is no history of a respiratory or gastrointestinal infection or administration of any medications before the onset of the rash. His immunizations are up to date, and he does not have any allergies. The family history is …

Visual Diagnosis: Stool Passage of a White Ribbonlike Object in an Adventurous Eater

1. Nurul I. Hariadi, MD* 2. Nava Yeganeh, MD† 3. Jennifer Dien Bard, PhD‡ 4. Natascha Ching, MD§ 1. *Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Michigan, Ann Arbor, MI. 2. †Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA Medical Center, Los Angeles, CA. 3. ‡Department of Pathology and Molecular Medicine, Queen's University School of Medicine, Kingston, Ontario, Canada. 4. §Pediatric Infectious Diseases, ‘Specially For Children, Dell Children's Medical Center of Central Texas, Austin, TX. A previously healthy 5-year old boy passes white ribbonlike objects in a bowel movement that are removed in multiple segments (Fig. 1). The specimens are sent to the microbiology laboratory, and the patient is seen in the pediatric infectious diseases clinic. Before the episode, he had normal appetite with no abdominal pain, diarrhea, constipation, flatulence, cough, or any other constitutional symptoms. He complains of intermittent periumbilical pain after the episode but has no other symptoms. Figure 1. Multiple white ribbonlike segments measuring approximately to 3 to 10 in. Further questioning of the patient and family reveals sophisticated and adventurous eating habits. He has been eating raw fish for 1 year before presentation, including salmon and tuna sushi and sashimi. He eats rare beef and lamb and tries delicacies such as cooked crickets, ants, and scorpions. He has three cats with fleas and feeds Koi fish in a pond but has no contact with other animals. During recent travel to Sierra, California, he swam in a cave pond but did not drink its water. He also visited Kauai, Hawaii, 2 months ago but did not consume sushi, sashimi, or Hawaiian delicacies of raw fish there. Findings on his physical examination are normal, his weight is at the 25th percentile, and his height is between the 10th and 25th percentiles. Complete blood cell count reveals no evidence of anemia. The white blood cell count is 9.6×103/μL (9.6×109/L) with a normal differential count, hemoglobin is 13.0 g/dL (130 g/L), hematocrit is 38.2% (0.38), and platelet count is 258×103/μL (258×109/L). Mean corpuscular volume is 84.1 …

Oral Manifestations in HIV/AIDSInfected Children

To assess factors influencing the distribution of oral manifestations in HIV/AIDS-infected children attending the Paediatric Infectious Disease Clinic in Mulago Hospital, Kampala. This was a cross-sectional study comprising 237 children (males/females: 113/124) aged 1 to 12 years. The parents/guardians were interviewed to obtain demographic information, oral hygiene practices, dietary habits and health seeking behaviours as well as any medications taken. The children were clinically examined for oral lesions based on World Health Organization criteria with modifications. About 71.7% of the children cleaned their teeth. About 16.9% of the children had visited a dentist since birth, mainly for emergency care. One or more oral lesions were recorded in 73% of the children of whom 19.0% experienced discomfort during oral functions. Cervical lymphadenopathy, oral candidiasis and gingivitis were the most common soft tissue oral lesions: 60.8%, 28.3% and 19.0%, respectively. Except for dental caries, the overall frequency distribution of soft tissue oral lesions was significantly lower in children on highly active antiretroviral therapy (HAART) as compared to their counterparts not on HAART. The prevalence of dental caries in deciduous and permanent dentitions was 42.2% and 11.0%, respectively. Tooth brushing and previous visits to the dentist were indirectly and significantly associated with dental caries. About 5.9% (n=14) of the children had <200 CD3 + CD4 T-lymphocyte cells per μl of blood. The majority of the children had one or more oral lesions, particularly in the group not on HAART. Some of the lesions were associated with discomfort during oral functions.

Disclosure of HIV status to infected children in a Nigerian HIV Care Programme

With increasing survival of HIV-infected children, parents face the challenges of disclosure to the children. The aim of this study was to assess the rate of HIV disclosure to children in Ibadan and the factors influencing it in order to guide design of strategies for successful disclosure. A semi-structured questionnaire was administered to consecutive consenting caregivers of HIV-infected children aged ≥6 years attending the Paediatric Infectious Disease Clinic of the University College Hospital, Ibadan, between November 2008 and October 2009. Caregivers of 96 children (46 boys, 50 girls) infected with HIV were interviewed. The ages of the children ranged from 6 to 14 years with a mean (SD) of 8.8 (2.2) years. Disclosure had been done in only 13 (13.5%) of the children; ages at disclosure ranged from 4.5 to 13 years with a mean of 8.7 (SD = 2.2). Disclosure was associated with age above 10 years. Reasons given by carers for non-disclosure in 83 caregivers included inability of the children to understand in 53 (63.9%), fear of disclosure to other children 34 (41.0%), fear of disclosure to family/friends in 28 (33.7%), fear of psychological disturbance of the children in 26 (31.3%) and fear of blaming the parents in 22 (26.5%). Twenty (20.8%) of the children have asked questions relating to their diagnosis and the responses are often evasive. Caregivers felt disclosure had helped adherence to antiretroviral therapy in 7 (63.6%) of the 11 children on antiretroviral drugs in whom there was disclosure but no effect on the remaining. There is a need to assist parents and health care providers in successfully disclosing HIV status to infected children without adverse consequences.

Study of Hepatic functions and prevalence of Hepatitis B surface Antigenaemia in Nigerian children with human immunodefiency virus infection

HIV and hepatitis B virus (HBV) co-infected patients have a significantly increased risk of dying from liver disease especially after starting treatment with highly active antiretroviral therapy. We aim to determine the prevalence of hepatitis B surface antigenaemia in HIV-infected children and their significance in relation to hepatic functions. Two hundred and eighty four HIV-infected children aged between 4 mouths to 15 years attending the Paediatric infectious disease clinic of University of Maiduguri Teaching Hospital (UMTH) Maiduguri, Nigeria from September 2007 to December 2007 were the subject for this study. Two hundred and seventy six HIV-negative children with served as age and sex-matched controls. They underwent investigations to evaluate the liver function (serum alanine transferase (ALT), alkaline phosphotase (ALP) and bilirubin) and the prevalence of hepatitis B surface antigen (HBsAg) using ELISA technique. Prevalence of HBsAg of 19% and 9.4% was observed among HIV-infected children controls (p = 0.004). Serum ALT and bilirubin concentrations were significantly higher in the HIV-infected group compared to the controls, (p < 0.05). HIV-infected children with HBs antigenaemia had significantly higher ALT and ALP concentrations compared to those without HBs antigenaemia (p < 0.05). These findings point to the high risk of HBV infection and continual paranchymal damage in HIV-infected children before commencing ART. Vaccination against HBV should eliminate this risk. Ideally HBV serology should be evaluated before starting ART to help guide therapeutic decision-making.

Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy

To describe lipid profile, body shape changes, and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy. We investigated 43 children and adolescents being treated with this therapy at the outpatient clinic of pediatric infectious diseases of Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. Values of total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were determined. We also performed glucose tolerance test and analyzed body fat distribution, nutritional status, dietary intake, and family history of cardiovascular risk. The statistical analysis was performed using Student's t test. Significance level of p-value was lower than 0.05. We found lipid abnormality in 88.3% and body shape change in 13.9% of the cases. Nutritional status was adequate (81.3%) in most of the study population. Cholesterol intake in children older than 9 years was above the recommended value. Prevalence of dyslipidemia and, therefore, risk for cardiovascular diseases were high during the use of highly active antiretroviral therapy.