Seroprevalence of HIV-1 and HIV-2 infection among children diagnosed with protein-calorie malnutrition in Nigeria

Abstract

Excessive weight loss due to protein calorie malnutrition (PCM) is a significant problem in Nigerian children. This syndrome may be difficult to differentiate from the wasting disease caused by human immunodeficiency virus type 1 (HIV-1) infection. We studied 70 children admitted to the Baptist Medical Center in Ogbomosho, Nigeria in 1990 with PCM for prevalence of antibodies to HIV-1 and HIV-2. The cohort was from low-risk mothers and had a median age of 25 months (range, 4 months-9 years) with a weight deficit of at least 20% of the theoretical weight for age. Two sera were positive for anti-HIV-1 by both ELISA and Western blot (WB). A high prevalence of samples negative for HIV-1 antibody by ELISA were repeatedly reactive (11%, 8/70) or indeterminate (46%, 32/70) by WB. None of the sera was positive for antibody to HIV-2. There was no correlation of ELISA positivity or extent of WB banding with successful recovery from malnutrition. These results indicate a relatively low but significant prevalence of HIV-1 infection in Nigerian children with PCM. The high prevalence of indeterminate reactions in WB assays for HIV-1 suggests that other procedures may be necessary for confirmatory diagnosis of HIV-1 infection in this African population.

Study of ecology of malnutrition with respect to infection, infestation pattern, immunization and feeding practices in children attending tertiary care hospital

“…12,13 In this study we did HIV 1 and 2 ELISA for only children who were aged more than 18 months after taking consent from parents. HIV seropositivity was seen in 11.76% (8/68) of children.…”

Human immunodeficiency virus status in malnourished children seen at Lagos

“…Malnutrition, although mainly attributed to nutritional deficiency, may be multifactorial in origin and the malnourished state which is usually accompanied by some degree of immunocompromise predisposes to infections generally and this does not exclude the HIV infection. The World Health Organization (WHO) actually classifies wasting as a Stage 3 AIDS condition[ 8 – 9 ] and thus distinguishing malnutrition from the former clinically sometimes can be sometimes difficult thus it is worthwhile screening malnourished children for HIV infection.…”

“…The prevalence of HIV in malnourished children has varied over the years, depending on the characteristics of the group of children studied. In 1990, Fischer et al [ 9 ] documented a prevalence of 3% in south West Nigeria. However, other reports gave a higher prevalence in this group of children, ranging from 8.6% in Niger Republic [ 10 ] to 12% in Central African Republic.…”