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Published on: March 30, 2014
Clinically directed selective screening for HIV infection in hospitalized children
Sandeep B Bavdekar1, Rinku Agarwal
1Department of Pediatrics, Seth GS Medical College and KEM Hospital, Parel,Mumbai 400 012, India. drsbavdekar@vsnl.com
Insights
The likelihood of a child having HIV increases with the number and type of clinical signs present. Certain symptoms like oral thrush and dermatitis significantly indicate potential HIV infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Human Immunodeficiency Virus (HIV) infection presents with non-specific symptoms in children, leading to frequent testing.
- Limited research exists on the probability of HIV infection based on specific clinical manifestations in pediatric populations.
Purpose of the Study:
- To ascertain the probability of HIV infection in hospitalized children presenting with one or more selected clinical manifestations.
- To identify key clinical indicators associated with HIV seropositivity in children.
Main Methods:
- A prospective study enrolled 115 children (aged ≥18 months) admitted to a tertiary care center in Mumbai, India.
- Participants presented with various symptoms including chronic diarrhea, malnutrition, cough, lymphadenopathy, oral thrush, hepatomegaly, recurrent infections, dermatitis, parotid swelling, tuberculosis, or Pneumocystis pneumonia.
- HIV testing was performed using the WHO-UNAIDS strategy II, with data analyzed using SPSS software.
Main Results:
- Out of 115 children, 23 (20%) tested positive for HIV.
- HIV seropositivity rates varied by manifestation, ranging from 9.1% for chronic diarrhea to 83.3% for chronic dermatitis.
- Oral thrush, generalized dermatitis, and generalized lymphadenopathy were identified as significant independent predictors of HIV seropositivity.
Conclusions:
- The probability of HIV infection in children is directly related to the presence and number of specific clinical manifestations.
- The co-occurrence of multiple risk factors increases the likelihood of HIV infection in pediatric cases.
Background:
As HIV infection presents with several manifestations, none of which is specific, several children are subjected to HIV testing. Very few studies have examined the issue of probability of HIV infection with a given clinical manifestation.
Aim:
To determine the probability of HIV infection when a child is hospitalized with at least one of the selected manifestations.
Material And Methods:
Children aged 18 mo and above, admitted to a tertiary care center in Mumbai, India with chronic diarrhea, severe malnutrition, persistent cough, generalized lymphadenopathy, oral thrush, hepatomegaly, repeated common infections, generalized dermatitis, chronic parotid swelling, recurrent bacterial infection, disseminated tuberculosis and/ or Pneumocystis carinii pneumonia were enrolled in a prospective study after obtaining informed consent. They were subjected to HIV testing using WHO-UNAIDS strategy II. The data obtained was analyzed using the Statistical Package For Social Sciences (SPSS) software program.
Results:
Twenty-three (20 PERCENT) of the 115 children enrolled tested positive for HIV. The seropositivity rate for various features ranged from 9.1 PERCENT for chronic diarrhea to 83.3 PERCENT for chronic dermatitis. Oral thrush, generalized dermatitis and generalized lymphadenopathy were the significant independent clinical risk factors for predicting HIV seropositivity. The probability of HIV infection was higher in children who had higher number of risk factors present concomitantly
Conclusions:
The probability of HIV infection in a child is dependent upon the nature and number of manifestations present.
