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Clinical spectrum of HIV infection
R Dhurat1, M Manglani, R Sharma
1Department of Dermatology and Division of Pediatric Hematology-Oncology, L.T.M.M. College and L.T.M.G. Hospital, Sion, Mumbai 400 022, India.
Insights
Perinatal transmission is the primary route for pediatric human immunodeficiency virus (HIV) infection, leading to distinct clinical symptoms in children. Transfusion-acquired HIV infection presents differently, with most children remaining asymptomatic initially.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- Human immunodeficiency virus (HIV) infection in children poses significant public health challenges.
- Understanding transmission routes and clinical presentations is crucial for effective management.
Purpose of the Study:
- To investigate pediatric HIV transmission modes.
- To characterize clinical manifestations in children with HIV.
- To compare perinatal versus transfusion-acquired HIV infection clinical spectra.
Main Methods:
- A case series study was conducted at a hospital-based pediatric HIV clinic.
- Data were collected from children diagnosed with HIV infection.
- Clinical details and transmission routes were recorded.
Main Results:
- Perinatal transmission accounted for 74.5% of pediatric HIV cases, with 90.2% symptomatic, often presenting with tuberculosis and failure to thrive.
- Transfusion-acquired HIV infection (21.8%) predominantly presented asymptomatically.
- Mortality rates were higher in perinatally infected children compared to those with transfusion-acquired infections.
Conclusions:
- The perinatal route is the predominant mode of HIV transmission in children.
- Clinical manifestations of pediatric HIV differ significantly from adult presentations.
- HIV infection acquired through different routes exhibits distinct clinical trajectories.
Objective:
To study the modes of transmission of pediatric HIV infection, to categorize clinical manifestations and to compare clinical spectrum of perinatal with transfusion acquired HIV infection.
Design:
Case series study.
Setting:
Hospital based pediatric HIV clinic.
Methods:
Children confirmed to have HIV infection were evaluated and relevant details recorded.
Results:
55 children were enrolled of whom 41 (74.5%) had perinatal transmission of HIV, 12 (21.8%) were infected through blood transfusions and 2 (3.6%) through other routes. Thirty-seven (90.2%) of the 41 perinatally infected children were symptomatic. Tuberculosis was seen in 25 (67.5%) of these children and failure to thrive in 18 (48.6%). Nonspecific features such as recurrent bacterial infection, oral candidiasis and chronic diarrhea were other manifestations. Eight (26.3%) of the 30 children available for follow up for a median period of 9 months died at the median age of 8.5 months. Amongst the transfusion acquired HIV infection, 11 (91.6%) of the 12 were asymptomatic at presentation. Six (50%) of these children died at the median age of 3 years and the remaining 6 had no major symptoms at a median follow up of 3.5 years.
Conclusion:
Perinatal route is the major route of HIV transmission in children and clinical manifestations are different from those of adults.