Profile Of HIV Infected Children Research Articles

Sociodemographic and pharmacoepidemiology profile of HIV infected children

RESUMO A terapia antirretroviral interfere na replicação do vírus HIV, impede a progressão da infecção para a Aids e previne a mortalidade precoce das crianças infectadas. Esta pesquisa investigou o perfil sociodemográfico e os parâmetros relacionados com o tratamento antirretroviral das crianças HIV positivas residentes no estado do Paraná. Trata-se de um estudo observacional descritivo e analítico realizado com dados secundários do ano de 2020 referentes às crianças com até 12 anos de idade. Foram investigados: perfil, prevalência, medicamentos em uso, abandono da terapia, resistência e supressão viral. Foram identificadas 148 crianças, com uma prevalência igual a 8,1/100 mil no Paraná. Apesar de todas as crianças diagnosticadas com HIV terem iniciado o tratamento, 17,2% encontravam-se em abandono da terapia antirretroviral. Entre as crianças que permaneciam em tratamento, 9,8% não atingiram a supressão viral e suas cargas virais comumente ultrapassavam mil cópias virais/mL. Houve um predomínio de esquemas medicamentosos provavelmente prescritos após falhas terapêuticas. Os resultados indicam que o Paraná apresenta bons resultados quanto ao início rápido da terapia e à supressão viral das crianças. Entretanto, existe um número considerável de abandonos da terapia e de falhas terapêuticas, indicando a necessidade de reforçar a vinculação desta população aos serviços de saúde.

Study of clinical profile of HIV infected children and the response to Anti-retroviral therapy at ART centre, Government general hospital,Kakinada

Study of clinical profile of HIV infected children and the response to Anti-retroviral therapy at ART centre, Government general hospital,Kakinada

Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count

Aims: To study the clinical profile of HIV infected children and correlate them with the CD4 count at the time of presentation.
 Study Design: Hospital based observational study
 Place and Duration of Study: ART centre of SCBMCH and Department of Pediatrics, SVPPGIP, Cuttack, Odisha during the period October 2017 to September 2019.
 Methodology: All children aged between 1.5 to 15 years who were confirmed to be HIV positive by ELISA or immunocomb II, either at present or past were included in the study. They were subjected to CD4 count testing, along with nutritional assessment and screened for opportunistic infections, apart from their socio-demographic details. All quantitative variables including age, weight, height, were compared by unpaired t-test. Categorical variables like sex mode of transmission were compared by chi-square test. Variables like clinical staging, immunological staging and CD4 counts were measured at presentation and analyzed with repeated ANOVA at 5% level of significance to allow for multiple comparisons. P<0.05 was considered significant and inferences were drawn.
 Results: Out of 103 cases, majority belonged to age 4- 7 years and 59.2% were malnourished. 24.3% were asymptomatic, with the most common clinical features noted were fever (65%), cough (47.8%), recurrent diarrhoea (41.8%) and weight loss (40.8%). The incidence of opportunistic infections was 24.3%, with tuberculosis (40%) and herpes zoster (36%) leading the list. Most cases (37.87%) came under WHO clinical stage-III. A significant correlation was found between CD4 count and age, WHO clinical staging, opportunistic infections in the population. Lower CD4 counts were associated with younger age, lower staging and less risk for symptoms and infections.
 Conclusion: CD4 count is a reliable market to assess the staging and risk for opportunistic infections in pediatric HIV and thus can be used as screening tool for complications/ deterioration in the child, for better management.

Clinical Profile of HIV Infected Children 18 months – 15 years of Age

Clinical Profile of HIV Infected Children 18 months – 15 years of Age

Profile of HIV infected children

Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake.The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in patients with liver disease (LD). It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference.EN by means of ONS is recommended for patients with chronic LD in whom undernutrition is very common. ONS improve nutritional status and survival in severely malnourished patients with alcoholic hepatitis. In patients with cirrhosis, TF improves nutritional status and liver function, reduces the rate of complications and prolongs survival. TF commenced early after liver transplantation can reduce complication rate and cost and is preferable to parenteral nutrition. In acute liver failure TF is feasable and used in the majority of patients.The full version of this article is available at www.espen.org.

Impact of antiretroviral therapy on the biological profile of HIV infected children in Cameroon

Background: HIV infection in children is a public health problem in ressource-constrained settings. Despite the support of the international community, meeting the cost of treatment and biological follow up remains a challenge in Cameroon and the developing world as a whole. The aim of this study was to evaluate the impact of antiretroviral therapy on the biological profile of HIV infected children followed up at the University Teaching Hospital of Yaounde (UTHY) in Cameroon. MethodsM p= 0.007), percentage of CD4 in children below 5 years of age of 4.62% (20.12-24.75; p=0.022), absolute value of CD4 in children above 5 years of 294 cells/mm3 (151.18-445.18; p=0.011), CD4/CD8 ratio of 0.35 (0.550.90; p=0.000). Interestingly, after six months of therapy, there was a decrease in viral load of 3.90 log 10 copies/ml (5.85-1.95; p=0.006). Conclusion: This study demonstrated that immune restoration and virologic suppression in children were obtained after six months of therapy. Therefore, making biological follow up affordable to this vulnerable group is essential in our quest for a good therapeutic outcome.

Profile of HIV infected children: A hospital based study at Eastern Nepal

ObjectiveTo investigate the clinical, laboratory, epidemiological profiles and outcome in human immunodeficiency virus infected Nepalese children. MethodsThis was a hospital based prospective study. Human immunodeficiency virus-infected children presenting to pediatric immunology clinic at BP Koirala Institute of Health Sciences were enrolled and followed up. ResultsMedian age at diagnosis among 39 enrolled children was 58 months. All children acquired infection vertically. Unsafe sex (74.4%) and intravenous drug use (25.6%) were the major risk behaviors in fathers. At presentation, 20.8% children were asymptomatic, 54.0% were malnourished, 41.0% were in WHO clinical stage 1, 17.9% were in stage 4, 74.4% were anemic, 17.9% had thrombocytopenia and median CD4 count was 543. Fever, lymphadenopathy, hepatosplenomegaly, skin eruptions and oral lesions were common presenting features (16.2%, 16.2%, 13.5%, 10.8%, and 8.1% respectively out of 74 features). Tuberculosis (16.0%), chronic otitis media (12.0%), scabies (10.7%), bacterial pneumonia (9.3%) and oropharyngeal candidiasis (6.7%) were common opportunistic infections. Antiretroviral treatment was started in 18 (46.2%) cases at median age of 67 months. Median change in CD4 count at follow up was significantly different between the groups receiving and not receiving antiretroviral treatment (+192 vs. −72; P=0.045). ConclusionsInfection in children is vertical. Undernutrition, anemia, fever, lymphadenopathy, hepatosplenomegaly, skin eruptions, and ear discharge are common presenting features. Opportunistic infections are common and tuberculosis is the most common opportunistic infection followed by chronic ear infection, scabies, candidiasis and bacterial pneumonia. Timely antiretroviral treatment improves immune response.

A STUDY ON PREVALENCE OF ANEMIA AND GROWTH PATTERN AMONG HIV-INFECTED CHILDREN FROM RURAL AREAS ATTENDING GOVT. GENERAL HOSPITAL, VIJAYAWADA, ANDHRA PRADESH, INDIA

The present communication deals with the profile of HIV infected children belonging to pre-HAART (pre-Highly Active Anti Retroviral Therapy) era and HAART era to know the status of anemia and growth pattern who attended the ART centre, Govt. General Hospital, Vijayawada, Andhra Pradesh, India. A cross-sectional record based study was carried out in 125 HIV infected children in ART centre from 2009 to 2011. Hemoglobin, height, weight, BMI, waist and hip ratio were calculated according to the standard protocols. The CD4 count was estimated using BD FACS caliber flow cytometer and results were statistically analyzed. According to the present study 125 subjects of age group 1-20 years were chosen. The subjects in pre-HAART era (75 subjects) showed low level of Hb content 6.9 gm/dL in male and 6.3 gm/dL in female subjects; the mean BMI level was 20.43 in male and 18.47 in female subjects and showed a significant increase (p<0.05) in mean CD4 counts from 592 to 790 cells/cmm from baseline count to follow up count after 18 months. The study patients in HAART era (45 subjects) significant decrease (p<0.001) in Hb content from 7.3 to 6.5 gm/dL and significant increase (p<0.05) in BMI level from 18.1 to 22.6 and showed a significant increase (p<0.001) in CD4 counts from 174 to 902 cells/cmm from baseline to follow up treatments. Our study reinforces the finding that anemia, growth pattern of HIV infection in Indian children with prognostic significance.

Profile of HIV infected children from Delhi and their response to antiretroviral treatment

(i) To study the clinical and immunological profile of HIV infected children attending the ART centre; (ii) To correlate CD4 count with clinical staging at diagnosis; and, iii) To study the clinical and immunological response to antiretroviral treatment. Antiretroviral therapy (ART) centres of two tertiary care hospitals of Delhi. 100 children attending the centres between December 2008 to June 2009. The clinical features, immunological profile (CD4 count) and response to ART were recorded in a structured proforma. Prospective follow-up. Average age of enrolled children was 6.24 y (range 1-14 years) and mode of transmission was parent to child in 92%. Most common clinical presentation was fever (83%), cough (50.8%) and diarrhea (38.9%). Tuberculosis was the most common opportunistic infection seen in 11% of children. 59% of enrolled children were malnourished. Antiretroviral treatment (ART) was initiated in 33 children. Children who were initiated on ART had a significant improvement in both clinical and immunological staging at the 6 months follow up. Immunological response (rise in CD4 count) to ART was better in children with lesser degree of immunosuppression. The measure of agreement between the clinical and immunological stage at presentation was poor. Baseline CD4 counts rather than clinical staging can be a primary determinant for initiation of antiretroviral treatment in HIV infected children.

Clinical manifestations of HIV infected children.

Heterosexual contact is the predominant mode of transmission among adults in India with an increasing number of women of childbearing age becoming infected with HIV. Consequently, children in India increasingly getting infected, primarily from vertical transmission. A retrospective review of the profile of HIV infected children attending an HIV clinic in South India is reported. All HIV-infected children under 15 years of age at the time of first presentation and managed at this center between June 1996 and June 2000 are included in this report. Socio-demographic characteristics and clinical manifestation were collected in a precoded proforme. A complete physical examination and baseline laboratory investigations were performed at entry into the clinic and at subsequent follow-up. Fifty-eight HIV-infected children were included: thirty-nine (67.2%) were male with mean age 4 years. Perinatal transmission was the predominant mode of HIV acquisition (67%). Common clinical manifestations in these children at presentation included oral candidiasis (43%), pulmonary tuberculosis (35%), recurrent respiratory infections (26%), bacterial skin infection (21%), papulo-pruritic dermatitis (19%), hepatosplenomegaly and lymphadenopathy (14%) each and chronic diarrhea (7%). An understanding of the epidemiology of pediatric HIV infection may reveal opportunities to reduce and perhaps eliminate perinatal transmission. Knowledge of clinical manifestations in this setting will help physicians meet the management challenges presented by HIV infected children.

Pediatric admissions with human immunodeficiency virus infection at a regional hospital in Soweto, South Africa.

The prevalence and clinical spectrum of HIV disease in hospitalized African children has not been adequately characterized in Southern Africa. This study aimed to determine the prevalence and disease profile of HIV infected children under 5 years of age admitted to a tertiary care hospital in Soweto, South Africa and to assess the impact of pediatric HIV on health services. Over a 6-month period, serial pediatric admissions to one of the children's wards were screened for HIV. Data on demographics and disease profile were recorded for all patients. A total of 549 patients were admitted, of whom 507 were tested for HIV; 29.2 per cent were considered to be truly infected. Previous admissions to hospital were more frequent in the HIV infected group, 48 per cent compared with 20.4 per cent of HIV uninfected children (p < 0.01), with a median length of stay of 8 days compared with 6 days (p < 0.01). There were more malnourished children in the HIV infected group (65.8 per cent compared with 33.1 per cent) (p < 0.01) and more died (17 per cent compared with 4.6 per cent) (p < 0.01). The most common reasons for admission in all children were infectious diseases such as pneumonia and gastroenteritis (85 and 31.9 per cent compared with 51 and 22.5 per cent, respectively in the HIV infected and uninfected groups, p < 0.01 and p < 0.03). It was concluded that pediatric HIV infection accounts for almost a third of childhood admissions to this hospital and has become a significant burden on the health service.