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[Digestive pathology in children infected with the human immunodeficiency virus (HIV), in Santiago de Chile]
Renzo Tassara1, Teresa Alarcón, Carmen Larrañaga
1Departamento de Pediatría, Campus Occidente, Facultad de Medicina, Universidad de Chile, Hospital San Juan de Dios, Servicio de Salud Metropolitano Occidente, Minsal. rtassara@machi.med.uchile.cl
Insights
Gastrointestinal problems are common in children with human immunodeficiency virus (HIV). Early diagnosis through endoscopy is crucial for managing digestive issues in pediatric HIV patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Clinical Medicine
Context:
- The epidemiology of human immunodeficiency virus (HIV) impacts a growing number of children globally.
- Digestive and respiratory systems are primary targets for HIV disease progression in pediatric populations.
- Understanding gastrointestinal manifestations is key to comprehensive pediatric HIV care.
Purpose:
- To document and analyze the spectrum of gastrointestinal problems encountered in HIV-infected children.
- To highlight the prevalence and types of digestive system complications in this vulnerable group.
- To evaluate the utility of endoscopic procedures in diagnosing these conditions.
Summary:
- A study of 24 HIV-infected children (aged 1-12) revealed high rates of gastrointestinal issues, including oral candidiasis (88%) and diarrhea (75%).
- Chronic diarrhea was noted in 8 children, with Cryptosporidium parvum identified as a frequent pathogen.
- Endoscopic findings showed inflammatory changes in the upper gastrointestinal tract of all examined patients.
Impact:
- Digestive health issues are prevalent and require active surveillance in pediatric HIV patients.
- Endoscopy serves as a vital diagnostic tool for early detection of gastrointestinal complications.
- This research underscores the importance of a multiprofessional approach to managing HIV in children.
Background:
Human immunodeficiency virus (HIV) epidemiology has changed, affecting an increasing number of children. As in adults, the disease predominantly affects the digestive and respiratory systems.
Aim:
To report the gastrointestinal problems in HIV infected pediatric patients.
Patients And Methods:
Twenty four HIV infected children (nine male, aged 1 to 12 years old, followed for 1 to 170 months), are reported. This group has been under care by a multiprofessional team.
Results:
Oral candidiasis was present in 21 (88%), esophagic candidiasis in 3 (13%), oral ulcers in 4 (17%). Diarrhea was observed in 18 children (75%) and in eight, it had a chronic evolution. Cryptosporidium parvum was the most frequent agent found in six cases (1 with acute and 5 with chronic diarrhea). Schlerosing cholangiopathy was observed in one case, with a fatal outcome, in association to microsporidiosis. Upper endoscopy was done in 11 patients, demonstrating microscopic inflammatory changes in esophagic, gastric and duodenal epithelia in all.
Conclusions:
Digestive problems are common in HIV infected pediatric patients. They must be always sought actively. Endoscopy is a valuable tool for the early diagnosis of these problems.
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