Clinico-laboratory profile of pediatric HIV in Karnataka

Objective. To study the clinical manifestations and incidence of opportunistic infections in HIV/AIDS seropositive proven hospitalized children. Methods. Proven HIV seropositive children aged between 18 months to 12 years, admitted between April 2004 to June 2005 (15months) to pediatric medical ward, KIMS, Hubli, were enrolled. Socio-demographic characteristics and clinical manifestations were recorded in the predesigned proforma. A complete physical examination and laboratory investigations were performed at the time of admission. Children were categorized as per 1994 revised CDC classification of pediatric HIV infection. Results. Number of HIV seropositive children admitted during study period was 71. Vertical transmission was noted in 94.37%, which is the major route of transmission. The common symptoms noted were persistent fever (70.42%), persistent cough (59.15%), loss of appetite (59.15%), loss of weight (56.33%) and recurrent diarrhea (30.99%). The common signs present were, hepatomegaly (69.04%), skin lesions (59.15%), lymphadenopathy (57.75%) and severe malnutrition (54.93%). The common opportunistic infections observed were tuberculosis (38.03%), recurrent diarrhea (30.99%), oral candidiasis (21.13%) and recurrent bacterial pneumonia (12.68%). Six (8.45%) children died during the study period, which included 4 (5.63%) cases of HIV-encephalopathy. Conclusion. Vertical transmission was the major route of HIV infection. Persistent fever, cough, loss of appetite and loss of weight were common presenting clinical features. Tuberculosis was the commonest opportunistic infection.