Persistent diarrhea associated with AIDS

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Chronic diarrhea and wasting are common in adults with Acquired Immunodeficiency Syndrome (AIDS) in developing nations.
• Protozoa and Mycobacterium avium-intracellulare are frequent pathogens in AIDS-related diarrhea.
• Data on children suggest common enteric pathogens affect HIV-positive and HIV-negative infants similarly.

Purpose of the Study:

• To investigate the relationship between human immunodeficiency virus (HIV) status and the progression and recurrence of diarrhea in infants.
• To assess the impact of HIV infection on infant mortality due to diarrhea.

Main Methods:

• A longitudinal study of 469 infants born to mothers with known HIV serostatus in Kinshasa, Zaire.
• Analysis of diarrhea progression, recurrence, and association with HIV infection and mortality.

Main Results:

• Infants who are HIV-positive showed a sixfold greater progression from acute to persistent diarrhea compared to HIV-negative infants.
• HIV-negative infants born to HIV-positive mothers had a 3.5 times higher risk of persistent diarrhea than those born to HIV-negative mothers.
• HIV-positive infants had a 2.3 times greater risk of recurrent diarrhea episodes and a strong association with diarrhea-related deaths, which accounted for 50% of mortality.

Conclusions:

• Infant HIV infection is strongly linked to increased risk and severity of diarrhea, contributing significantly to mortality.
• Interventions to improve child survival in populations affected by AIDS must target both maternal and infant HIV infections.