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Otitis media in children born to human immunodeficiency virus-infected mothers
E D Barnett1, J O Klein, S I Pelton
1Department of Pediatrics, Boston University School of Medicine, MA.
Insights
Human immunodeficiency virus (HIV) infection significantly increases the risk of recurrent acute otitis media (AOM) in children. HIV-infected children experienced substantially more AOM episodes, especially those with lower T4 lymphocyte counts.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Acute otitis media (AOM) is a common childhood illness.
- Children with human immunodeficiency virus (HIV) infection are presumed to have a higher incidence of AOM.
- Understanding AOM patterns in HIV-infected children is crucial for managing their health.
Purpose of the Study:
- To compare the incidence and recurrence of AOM in HIV-infected children versus those who seroreverted to HIV-negative status.
- To investigate the relationship between T4 lymphocyte counts and AOM episodes in HIV-infected children.
Main Methods:
- Retrospective cohort study comparing 28 HIV-infected children with 33 children who achieved HIV seroreversion by 18 months.
- Data collected on AOM episodes per year and T4 lymphocyte counts.
- Statistical analysis to compare AOM incidence and risk factors.
Main Results:
- HIV-infected children showed an increasing mean number of AOM episodes per year (1.89 to 2.40), while seroreverted children showed a decrease (1.33 to 0.13).
- By age 3, all HIV-infected children had experienced AOM, with 80% having 6+ episodes; none of the seroreverted children had 6+ episodes.
- HIV-infected children with decreased T4 lymphocyte counts had significantly more AOM episodes (2.35 vs. 1.18) and a nearly 3-fold increased risk of recurrent AOM.
Conclusions:
- HIV infection is associated with a significantly higher burden of recurrent acute otitis media in children.
- Lower T4 lymphocyte counts in HIV-infected children correlate with increased AOM frequency and recurrence.
- These findings highlight the impact of HIV on middle ear infections and the importance of immune status.
Abstract:
Acute otitis media (AOM) is thought to occur frequently in children infected with human immunodeficiency virus (HIV). We compared experience with AOM of 28 HIV-infected children with that of 33 children who seroreverted to HIV antibody negative status by age 18 months. The mean number of episodes/year of AOM for children who seroreverted decreased from 1.33 in the first year of life to 0.13 in the third year, whereas the mean number of episodes/year in HIV-infected children increased from 1.89 to 2.40. By age 3 years, all HIV-infected children had experienced 1 or more episodes of AOM, and 80% had experienced 6 or more, whereas 75% of children who seroreverted had experienced 1 or more episodes, and none had had 6 or more. HIV-infected children with normal T4 lymphocyte counts had a mean of 1.18 episodes of AOM in the first year of life compared with 2.35 episodes in HIV-infected children with decreased counts (P = 0.023). HIV-infected children with low counts had a nearly 3-fold increased risk of recurrent AOM (47% vs. 18%).