Clinical spectrum of Pediatric HIV across A.R.T. centers in Chhattisgarh
Abstract
Introduction: Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Few studies have been done about variable clinical manifestation of pediatric HIV infection in children. This study intends to know the clinical profile of HIV infection in children of Chhattisgarh, evaluate the seroconversion rates of babies born to HIV seropositive women, possible maternal, obstetrical, and feeding factors influencing them, patient’s adherence to ART and opportunistic infections in affected children.
Methods: All pediatric HIV cases from 1½ year to 14 year registered in A.R.T. centres of Chhattisgarh. Data were analysed using SPSS system version 21.
Result: A total of 414 children were evaluated from different A.R.T. centres in Chhattisgarh for final analysis. Male to female ratio is 1.38:1. Most common mode of transmission is from mother to child. Tuberculosis, Recurrent and Persistent Diarrhoea, Recurrent Pneumonia and Oral Candidiasis are common infection in most of the children.
Conclusion: Average age of diagnosis of pediatric HIV is around 7.5 ± 2.1years. Majority of children are diagnosed in stage 3. Adherence therapy to A.R.T. is good. Vertical transmission is most common mode of transmission.
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References
Weiss RA. How does HIV cause AIDS? Science. 1993 May 28;260(5112):1273-9.
Douek DC, Roederer M, Koup RA. Emerging concepts in the immunopathogenesis of AIDS. Annu Rev Med. 2009; 60:471-84. doi: 10.1146/annurev.med.60.041807.123549.
Dunn DT, Newell ML, Ades AE, Peckham CS. Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet. 1992 Sep 5;340(8819):585-8.
Leroy V, Newell ML, Dabis F, Peckham C, Van de Perre P, Bulterys M, Kind C, Simonds RJ, Wiktor S, Msellati P. International multicentre pooled analysis of late postnatal mother-to child transmission of HIV-1 infection. Lancet. 1998 Aug 22;352(9128):597-600 . PMID: 974601.
Pilcher CD, Shugars DC, Fiscus SA, Miller WC, Menezes P, Giner J, Dean B, Robertson K, Hart CE, Lennox JL, Eron JJ Jr, Hicks CB. HIV in body fluids during primary HIV infection: implications for pathogenesis, treatment and public health. AIDS. 2001 May 4;15(7):837-45.
Ammann AJ, Cowan MJ, Wara DW, Weintrub P, Dritz S, Goldman H, Perkins HA. Acquired immunodeficiency in an infant: possible transmission by means of blood products. Lancet. 1983 Apr 30;1(8331):956-8.
Gupta S, Gupta R, Singh S. Seroprevalence of HIV in pregnant women in North India: a tertiary care hospital based study. BMC Infect Dis. 2007 Nov 15;7:133. DOI: https://doi.org/10.1186/1471-2334-7-133.
Lodha R, Singhal T, Jain Y, Kabra SK, Seth P, Seth V. Pediatric HIV infection in a tertiary care center in North India: early impressions. Indian Pediatr. 2000 Sep;37(9):982-6.
Hazra R, Siberry GK, Mofenson LM. Growing up with HIV: children, adolescents, and young adults with perinatally acquired HIV infection. Annu Rev Med. 2010;61:169-85. doi: https://doi.org/10.1146/annurev.med.050108.151127.
Song R, Jelagat J, Dzombo D, Mwalimu M, Mandaliya K, Shikely K, Essajee S. Efficacy of highly active antiretroviral therapy in HIV-1 infected children in Kenya.Pediatrics. 2007 Oct;120(4):e856-61. Epub 2007 Sep 10.
Global AIDS Update 2016 - unaids. Available from http://www.unaids.org/sites/default/files/media_asset/global-AIDS-update-2016_en.pdf. Accessed on Ap.28th ,2016
India HIV Estimations 2015-Naco.Available from http://www.naco.gov.in/sites/default/files/India%20HIV%20Estimations%202015.pdf. Accessed on Ap.28th, 2016.
Peckham C, Gibb D. Mother-to-child transmission of the human immunodeficiency virus. N Engl J Med. 1995 Aug 3;333(5):298-302.
Minkoff H , Burns DN, Landesman S, Youchah J, Goedert JJ, Nugent RP, Muenz LR, Willoughby AD. The relationship of the duration of ruptured membranes to vertical transmission of human immunodeficiency virus. Am J Obstet Gynecol. 1995 Aug;173(2):585-9.
Dhurat R, Manglani M, Sharma R, Shah NK. Clinical spectrum of HIV infection. Indian Pediatr. 2000 Aug;37(8):831-6.
Dodd RY. Current viral risks of blood and blood products. Ann Med. 2000 Oct;32(7):469-74.
Kiwanuka N, Gray RH, Serwadda D, Li X, Sewankambo NK, Kigozi G, Lutalo T, Nalugoda F, Wawer MJ. The incidence of HIV-1 associated with injections and transfusions in a prospective cohort, Rakai, Uganda. AIDS. 2004 Jan 23;18(2):342-4.
Gisselquist DP. Estimating HIV-1 transmission efficiency through unsafe medical injections. Int J STD AIDS. 2002 Mar;13(3): 152-9. DOI: https://doi.org/10.1258%2F0956462021924820
Shah SR, Tullu MS, Kamat JR. Clinical profile of pediatric HIV infection from India. Arch Med Res. 2005 Jan-Feb;36(1):24-31.
Lodha R, Upadhyay A, Kapoor V, Kabra SK. Clinical profile and natural history of children with HIV infection. Indian J Pediatr. 2006 Mar;73(3):201-4.
Pol RR, Shepur TA, Ratageri VH. Clinico-laboratory profile of pediatric HIV in Karnataka. Indian J Pediatr. 2007 Dec;74(12):1071-5.
Merchant RH, Oswal JS, Bhagwat RV, Karkare J. Clinical profile of HIV infection. Indian Pediatr. 2001 Mar;38(3):239-46.
Daga SR, Verma B, Gosavi DV. HIV infection in children: Indian experience Indian Pediatr. 1999 Dec;36(12):1250-3.
Madhivanan P, Mothi SN, Kumarasamy N, Yepthomi T, Venkatesan C, Lambert JS, Solomon S. Clinical manifestations of HIV infected children. Indian J Pediatr. 2003 Aug;70(8):615-20.
Fru FS, Chiabi A, Nguefack S, Mah E, Takou V, Bogne JB, Lando M, Tchokoteu PF, Mbonda E. Baseline demographic, clinical and immunological profiles of HIV-infected children at the Yaounde Gynaeco-Obstetric and Pediatric hospital, Cameroon. Pan Afr Med J. 2014Feb3;17:87.PMCID: PMC4247732 doi: https://dx.doi.org/10.11604%2Fpamj.2014.17.87.3264
Diack MA, Signaté SH, Diagne Guèye NR, Syllab A, Diouf A, Diagne I, et al. Epidemiological and clinical aspects of pediatric HIV infections in Albert-Royer Pediatric hospital (Dakar, Senegal). Arch Pediatr. 2005; 12(4): 404-9. DOI: https://doi.org/10.1016/j.arcped.2005.01.011
Fetuga MB, Ogunfowora OB, Oyegunle VN, Thanni LO. A ten-year review of paediatric HIV/AIDS among hospitalized children in a Nigerian teaching hospital. Nig J Paediatr. 2005; 32(3) :29-32.
Shah I. Age related clinical manifestations of HIV infection in Indian children. J Trop Pediatr. 2005 Oct;51(5):300-3. Epub 2005 Jun 24.
Singh S, Jat KR, Minz RW, Arora S, Suri D, Sehgal S. Clinical profile of 516 children affected by HIV in a tertiary care centre in Northern India:14 years of experience. Trans R Soc Trop Med Hyg. Jun 2009; 103(6): 627-33. DOI: https://doi.org/10.1016/j.trstmh.2009.01.009
Brown BJ, Oladokun RE, Odaibo GN, Olaleye DO, Osinusi K, Kanki P. Clinical and immunological profile of pediatric HIV infection in Ibadan, Nigeria. J Int Assoc Physicians AIDS Care (Chic).2011Jan/Feb; 10(1) :49-53. DOI: https://doi.org/10.1177%2F1545109710385124.
Sphiwe Madiba. “Patterns of HIV Diagnosis Disclosure to Infected Children and Family a Paediatric Antiretroviral Program in South Africa”. World Journal of AIDS, 2012, 2, 212-221. DOI: http://dx.doi.org/10.4236/wja.2012.23027.
Mehta K, Ekstrand ML, Heylen E, Sanjeeva GN, Shet A. Adherence to Antiretroviral Therapy Among Children Living with HIV in South India. AIDS Behav. 2016 May;20(5):1076-83. doi: https://doi.org/10.1007/s10461-015-1207-7.
Vreeman RC, Wiehe SE, Pearce EC, Nyandiko WM. A systematic review of pediatric adherence to antiretroviral therapy in low- and middle-income countries. Pediatr Infect Dis J. 2008 Aug;27(8):686-91. doi: https://doi.org/10.1097/INF.0b013e31816dd325.
Gomber S, Kaushik JS, Chandra J, Anand R. Profile of HIV infected children from Delhi and their response to antiretroviral treatment. Indian Pediatr. 2011 Sep;48(9):703-7.
Lawn SD, Myer L, Bekker LG, Wood R. CD4 cell count recovery among HIV-infected patients with very advanced immunodeficiency commencing antiretroviral treatment in sub-Saharan Africa. BMC Infect Dis. 2006 Mar 21;6:59. doi: https://doi.org/10.1186/1471-2334-6-59.
Rajesh R, Vidyasagar S, Varma DM, Naik A, Hegde BM, Guddattu V, Kamath A. A prospective study of highly active antiretroviral therapy in Indian human immunodeficiency virus positive patients. Int J Risk Saf Med. 2013 Jan 1;25(1):53-65. doi: https://doi.org/10.3233/JRS-130580.
Kaufmann GR, Furrer H, Ledergerber B, Perrin L, Opravil M, Vernazza P, Cavassini M, Bernasconi E, Rickenbach M, Hirschel B, Battegay M: Swiss HIV Cohort Study. Characteristics, determinants, and clinical relevance of CD4 T cell recovery to <500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clin Infect Dis. 2005 Aug 1;41(3):361-72. Epub 2005 Jun 24.
García F, de Lazzari E, Plana M, Castro P, Mestre G, Nomdedeu M, Fumero E, Martínez E, Mallolas J, Blanco JL, Miró JM, Pumarola T, Gallart T, Gatell JM. Long-term CD4+ T-cell response to highly active antiretroviral therapy according to baseline CD4+ T-cell count. J Acquir Immune Defic Syndr. 2004 Jun 1;36(2):702-13.
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