A study of clinical spectrum of HIV infection in children at a tertiary care hospital

Abstract

Background: Pediatric HIV infection today represents a major setback to the child health. The wide clinical spectrum and paucity of relevant data from India makes early diagnosis difficult. Our aim was to study the clinical profile of pediatric patients with HIV infection. Methods: This cross-sectional study was conducted at a tertiary care hospital in central India over a period of 1.5 years. Children between 18 months and 15 years attending the antiretroviral therapy (ART) clinic, pediatric outpatient department or admitted in the pediatric wards, who were detected to be HIV positive (on 2 rapid tests) were enrolled. Perinatally exposed symptomatic children less than 18 months of age were also included. Results: Demographic data, clinical features, investigations were recorded in a pre-designed proforma. Of the 112 HIV positive children enrolled, 103 (91.96%) acquired infection through vertical transmission, 4 (3.57%) through blood transfusion, while in 5 (4.46%) the route of acquisition of infection could not be determined. 104 (92.8%) cases were symptomatic. The mean age at the onset of symptoms was 3+2.63 years (range 1 month to 12 years). The most frequent manifestations were failure to thrive, lymphadenopathy and skin manifestations. Positive correlation was found between the WHO clinical and immunologic stages; correlation coefficient was 0.275 (p = 0.005). Conclusion: Vertical transmission is the most common mode of acquiring HIV in the pediatric age group. The clinical manifestations of HIV infection are protean and mimic a number of other illnesses. A high index of suspicion would therefore help in early and appropriate diagnosis.