Clinico-immunological profile and outcome of antiretroviral therapy in HIV-positive children

Abstract

Objectives: To study the clinico-immunological, nutritional and growth characteristics of HIV-infected children and the impact of antiretroviral therapy (ART) on these parameters. Design: Retrospective study. Setting: Out-patient department of a paediatric ART centre, Delhi, India. Subjects: HIV-positive children registered at the paediatric ART centre of the hospital were enrolled (n 130). Anthropometric measurements were used to classify children into the type of malnutrition according to definitions of the WHO and US Centers for Disease Control and Prevention. Clinical and immunological status of the children was recorded as per WHO guidelines. First-line ART was started based on guidelines of the National AIDS Control Organization. Nutritional status and clinico-immunological characteristics were followed up annually in children receiving ART. Results: Of children #5 years of age (n 54), stunting was noted in 42?5 % contrary to wasting seen in only 12?9 %. In children .5 years of age (n 76), short stature (40?7 %) and underweight (39?4 %) were seen in almost equal proportions. Asymptomatic presentation was noted in 60?0 %. Following ART, a reduction in wasting was noted in 75?0 % of children #5 years of age, whereas only 44?4 % of underweight children .5 years of age showed an improvement after therapy. Stunting and short stature continued to persist in all in children (#5 years and .5 years, respectively). Clinico-immunologically, 67?5 % improved in clinical status and 62?5 % showed immunological improvement.

Outcome of highly active antiretroviral therapy in HIV- infected Indian children

“…There was an improvement in the overall clinical status of the children with fewer numbers of episodes of acute infections with time. This has been described in other studies in children [ 2 ],[ 4 ].…”

Evaluation of the Nutritional State of Children and Teenagers Infected by HIV Treated in a University Hospital in Abidjan (Côte d’Ivoire)

“…[14] In children aged more than 5 years, nineteen (10.7%) children were wasted. Higher prevalence of chronic malnutrition were reported by Chouldhary (42% for children ≤ 5 years of age and 40% for children>5 years of age) [9].…”

“…In the work of Chouldhary in India [9], the stage C represented 40%. Other authors like DIACK in Senegal [10] and Kariyo [11] in Burundi reported respectively in their series 57.14% and 84% of severe deficit.…”

HIV Morbidity and Mortality in the Pediatric Population of Côte d’Ivoire

“…Severe Acute Malnutrition was the leading cause of hospitalization in both groups (29.03% and 40%). The work of Kimani Murage in South Africa [16] and Choudhary in India, on the nutritional assessment of a HIV-infected children population revealed prevalences of 18% of severe acute malnutrition, 12.9% among children under 5 years and 39.4% in those over 5 years [17]. The early HIV/AIDS testing and malnutrition treatment improves the quality of life of children living with HIV.…”