Prevalence and clinical pattern of paediatric HIV infection at the University College Hospital, Ibadan, Nigeria: a prospective cross-sectional study

Abstract

BackgroundThe prevalence of Paediatric HIV infection is largely unknown in many countries in sub-Saharan Africa. This study was aimed at determining the prevalence, clinical pattern of HIV infection and outcome among new patients aged <15 years using age-specific diagnostic methods.MethodsA prospective cross sectional study was carried out using the provider initiated HIV testing and counselling (PITC) model. HIV rapid test in parallel was used for screening and confirmation was with HIV DNA PCR in children <18 months and Western Blot in children ≥ 18 months.ResultsA total of 600 children were enrolled with ages ranging between one day and 179 months. Male: female ratio was 1.2:1. HIV seroprevalence was 12.3% and after confirmatory tests, the prevalence was 10%. Fourteen (37.8%) of the children aged less 18 months were exposed but not infected. Mother-to-child transmission accounted for 93.3% of cases. Features predictive of HIV infection were diarrhoea, cough, weight loss, ear discharge generalized lymphadenopathy, presence of skin lesions, parotid swelling and oral thrush. About 75% presented in advanced or severe clinical stages of the disease, 56.8% had severe immunodeficiency while 50% had viral loads more than 100,000 copies/ml. Mortality rate was 14.3% among HIV positive compared with 11.3% in HIV negative children but was not significant. Among the HIV positive children, 26.7% were orphans.ConclusionsThe prevalence rate of HIV infection among new patients screened using the PITC model was high, majority resulting from mother-to-child transmission. Most children presented in advanced stages of the disease and mortality rate among them was high. Though, the study site being a referral centre might have contributed to the high prevalence observed in this study, there is a need to expand access to PMTCT services, ensure implementation of PITC in paediatric settings and expand support services for HIV infected children.

Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

“…Two PHIV children in the current study had present otorrhea whereas no HIV-uninfected child presented with otorrhea. Statistics were not completed given the small numbers, though other researchers have shown that HIV-infected children in Africa have significantly more present or past episodes of otorrhea [7] and significantly more episodes of recurrent otorrhea [12].…”

Principais manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapia antirretroviral altamente ativa

“…In all the studies analyzed, although they occurred in different regions and countries, oral manifestations were highlighted as a common feature in children infected with HIV virus. Most commonly found lesions were oral candidiasis in various forms 3 served in the analysis of Charts 1 to 4 and it will be further discussed in the course of this article.…”

“…The first three variants have been described as the types known to be associated with HIV infection nowadays 11 . Thus, it is possible to affirm that the opportunistic lesion most commonly associated with HIV-infected patients is oral candidiasis and that this finding is fundamental for the early diagnosis of AIDS [1][2][3]10,14,16,18,19 . In addition, this oral manifestation may serve as a marker of disease progression and immunosuppression 2,5,13,15 since its prevalence is related to lower values ofTCD4+ lymphocytes 1 .…”

“…Ogumbosi et al 3 study showed that the high number of deaths was related to pre-antiretroviral era and that lower mortality rates were observed when ART was instituted. On the other hand, Ponnamet al 12 observed that the administration of HAART increased thedisease's free time, with a consequent raise in patients' survival rates.…”

“…First cases of AIDS were reported in the mid-1980s and its heterosexual transmission has grown over time, affecting a large number of women of childbearing age and capable of transmitting HIV virus to their children 2 . This vertical transmission, from mother to child,is considered the main factor for the increasing prevalence of this disease in pediatric patients [2][3][4] and it can occur during pregnancy, childbirth or through breastfeeding 5,6 . HIV infection currently affects more than 2 million children under the age of 15 years old worldwide and it is associated with numerous life-long comorbidities for this population 6,7 .…”