Late Diagnosis of HIV Infection in Children: Prevalence and Outcome

Abstract

Background: Late diagnosis of HIV infection is an important cause of death in children. Objectives: To determine the prevalence of late diagnosed HIV infection in children, describe the socio-demographic characteristics and to analyze outcome of these children. Methods: From January 2015 to October 2016, we carried out a prospective analytical study in the pediatric departments of University Teaching Hospital of the Brazzaville. Late diagnosed HIV children were selected for this work. Data analysis was performed in univariate and multivariate with Epi Info 7.2.1. Results: Of the 6058 hospitalized children, 103 (1.7%) were selected, 57.3% were boys; the median age was 21.9 months (IQR, 17.8 -76.7 months). Children of low socio-economic status accounted for 68.0%, those motherless: 43.7%. None of the children were tested for HIV before hospitalization. Mothers had a low education level in 60.2% of cases and were unaware of prevention of mother-to-child transmission (PMTCT): 60.3%. Children mostly showed signs of stages 4 (49.5%), and 3 (31.1%) of HIV infection, immunodeficiency was severe for 68.0% of children. Children discharged from the hospital accounted for 62.1% of which 15.53% against medical advice. The case fatality rate was 37.9%. The risk factors for death in univariate analysis were: age < 12 months (OR = 8.66), maternal death (OR = 17.93), severe malnutrition (OR = 66.07), clinical stages 4 (OR = 66.07) and severe immunodeficiency (OR = 17.37). The main pathologies responsible for death were respiratory infections (38.5%) and diarrheal diseases (30

Advocacy care on HIV disclosure to children

“…Oko et al. () have identified the need for better screening to detect early infection and diagnose children with HIV before they are 1 year old and the disease progresses. Early discovery would avoid hospitalizations and guarantee the child's right to treatment.…”

Evaluation of HIV-1 DNA levels among adolescents living with perinatally acquired HIV-1 in Yaounde, Cameroon: A contribution to paediatric HIV cure research in Sub-Saharan Africa

“… 13 , 22 However, evidence on the dynamics of HIV-1 DNA levels in ALPHIV with late ART initiation is lacking in a geographical sub-region where late HIV-1 diagnosis is still of concern. 23 To gain insights into the persistence of HIV-1 DNA in sanctuary sites in this vulnerable population, it is essential to know what is the size of the reservoirs (total HIV-1 DNA levels) we are dealing with. Total HIV-1 DNA is a global biomarker of reservoirs that includes integrated and non-integrated viral genomes coding for both competent and defective viruses.…”