The Indian Journal of Pediatrics

, Volume 70, Issue 8, pp 615–620 | Cite as

Clinical manifestations of HIV infected children

  • Purnima Madhivanan
  • S. N. Mothi
  • N. Kumarasamy
  • T. Yepthomi
  • C. Venkatesan
  • John S. Lambert
  • Suniti Solomon

Abstract

Objective : Heterosexual contact is the predominant mode of transmission among adults in India with an increasing number of women of childbearing age becoming infected with HIV. Consequently, children in India increasingly getting infected, primarily from vertical transmission. A retrospective review of the profile of HIV infected children attending an HIV clinic in South India is reported.Methods : All HIV-infected children under 15 years of age at the time of first presentation and managed at this center between June 1996 and June 2000 are included in this report. Socio-demographic characteristics and clinical manifestation were collected in a precoded proforme. A complete physical examination and baseline laboratory investigations were performed at entry into the clinic and at subsequent follow-up.Results : Fifty-eight HIV-infected children were included: thirty-nine (67.2%) were male with mean age 4 years. Perinatal transmission was the predominant mode of HIV acquisition (67%). Common clinical manifestations in these children at presentation included oral candidiasis (43%), pulmonary tuberculosis (35%), recurrent respiratory infections (26%), bacterial skin infection (21%), papulo-pruritic dermatitis (19%), hepatosplenomegaly and lymphadenopathy (14%) each and chronic diarrhea (7%).Conclusion : An understanding of the epidemiology of pediatric HIV infection may reveal opportunities to reduce and perhaps eliminate perinatal transmission. Knowledge of clinical manifestations in this setting will help physicians meet the management challenges presented by HIV infected children.

Key words

Heterosexual Transmission HIV 

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References

  1. 1.
    UNAIDSReport on the Global HIV/AIDS Epidemic, UNAIDS June 2000. Geneva: Joint United Nations Program on HIV/ AIDS.Google Scholar
  2. 2.
    Raman RG, Bently ME, Divekar ADet al. Spread of HIV infection in married monogamous women in India.J AMA 1997(278); 2090–2092.Google Scholar
  3. 3.
    Newman S, Sarin P, Kumarasamy Net al. Marriage, Monogamy and HIV: A profile of HIV-infected women in South India.Int J STD and AIDS 2000 (11) : 250–253.Google Scholar
  4. 4.
    Grubman S, Oleske J. The maturation of an epidemic: update on pediatric HIV infection.AIDS 1993 (7 supp 1); S225–234.PubMedCrossRefGoogle Scholar
  5. 5.
    Mehra J. Reducing risk behavior related to HIV/AIDS, STDs and drug abuse among street children, unuplished National report, New Delhi. 1996.Google Scholar
  6. 6.
    Biswas J, Kumar AA, George AEet al. Ocular and systemic lesions in children with HIV.Ind J Pediatr 2000; 67 (10): 611.CrossRefGoogle Scholar
  7. 7.
    Daga SR, Verma B, Gosavi DVet al. HIV infection in Children: Indian experienceIndian Pediatr 1999 (36); 1250–1252.Google Scholar
  8. 8.
    WHO/UNAIDS.HIV in Pregnancy: A Review. 1999 Geneva: Joint United Nations Programme on HIV/AIDS.Google Scholar
  9. 9.
    Cultural influences on infant feeding beliefs of mothers.J Am Diet Assoc 1999 (99); 88–90.Google Scholar
  10. 10.
    Lakshman K, Nichter M. Contamination of medical injection paraphernalia used by registered medical practitioners in South India : an ethnographic study.Soc Sci Med 2000(51); 11–28.Google Scholar
  11. 11.
    Orphans and HIV: the second wave of the HFV epidemic.Ann N Y Acad Seien 2000 (918); 163–169.Google Scholar
  12. 12.
    Bernstein LJ, Krieger BZ, Novicket al. Bacterial infection in the acquired immune deficiency syndrome of children.Pediatric Infect Dis 1985 (4); 472–475.Google Scholar
  13. 13.
    Akpede GO, Ambe JP, Rabasa AIet al. Presentation and outcome of HIV-1 infection in hospitalized infants and other children in north eastern Nigeria.East African Med Journal 1997 (74); 21–27.Google Scholar
  14. 14.
    Merchant RH, Schroff RC, Gilada IS. Epidemiology HIV disease of the women and children of Bombay.AIDS. Reader 1998 (8; 3); 99–103,106.Google Scholar
  15. 15.
    Lodha R, Singhal T, Jain Y, Kabra S, Seth P, Seth V. Pediatric HIV infection in a tertiary care center in North India: Early Impressions.Ind Pediatr 2000(37); 982–986.Google Scholar
  16. 16.
    Kumarasamy N, Solomon S, Madhivanan Pet al. High plasma viral load in persons co-infected with HFV and Tuberculosis in South India.9th International Congress on Infectious Diseases. Buenos Aires, Argentina. April 10–13, 2000. Abstract: 78.022.Google Scholar
  17. 17.
    Connor EM, Andiaaman WA. In Pizzo Pa, Wilfert CM, eds.Lymphoid Interstitial Pneumonitis. Williams and Wilkins Co, Baltimore 1994:343–352.Google Scholar
  18. 18.
    Rubinstein A, Morreecki R, Goldman H. Pulmonary disease in infants and children.Clin Chest Med 1988 (9; 3); 507–517.PubMedGoogle Scholar
  19. 19.
    Church JA. Clinical aspects of HIV/AIDS infection in children.Paediatr Ann 1993; 22 (7).Google Scholar
  20. 20.
    Chadwick EG, Yogev R. Pediatric AIDS.PCNA 1995 (42; 4); 969–989.Google Scholar
  21. 21.
    Ranganathan K, Reddy VR, Dinaker Jet al. Oral and Maxillofacial manifestations among HIV positive children in Chennai, India.J Ind Dental Assoc (JIDA) 1998; (69) : 260–263.Google Scholar
  22. 22.
    Scott GB, Hutto C, Makuch RWet al. Survival in children with perinatally acquired human immunodeficiency virus type-1 infection.New Engl J Med 1989 (321); 1791–1796.Google Scholar
  23. 23.
    Lucas SB, Peacock CS, Hounnou Aet al. Disease in children infected with HIV infection in Abidjan, Cote’d Ivoire.BMJ 1996 (312); 335–338.Google Scholar
  24. 24.
    Usha MM, Rajendran R, Thyagarajan SPet al. Identification of Pneumocystis carinii in induced sputum of AIDS patients in Chennai.Ind J Path Micro 2000 (43) : 291–296.Google Scholar
  25. 25.
    Madelena L, Dragan I, Mihordea M. Clinical and immunological features of HIV/AIDS infection associated with chronic hypertrophie parotitis in children.Romanian J Virology 1995 (46:3-4); 135–143.Google Scholar
  26. 26.
    Task force on pediatric AIDS and perinatal HIV/AIDS infection.Pediatrics 1988 (82); 641–944.Google Scholar
  27. 27.
    Mahajan A, Reddy V, Kumarasamy Net al. Pathogenic profile of chronic diarrhea in HIV/AIDS patients in South India.5th Asia Pacific AIDS Conference ’99, Kuala Lumpur. Abstract No : 540/SAB02-03.Google Scholar
  28. 28.
    Evans HE. Human immunodeficiency virus infections. In Behrmaan RE, Klergman RM, Nelson WE, Vaughan VC.Textbook of Pediatrics, 14th edn. W.B. Philadelphia; Saunders Co 1992; 115–115.Google Scholar
  29. 29.
    Johnson JP, Nair P, Hines SEet al. Natural history and serologic diagnosis of infants born to HIV infected women.AJDC 1989 (143); 1147–1153.Google Scholar
  30. 30.
    Biswas, J, Therese L, Kumarasamy N, Solomon S, Yesudian P. Lid abscess with extensive molluscum contagiosum in a patient with acquired immunodeficiency syndrome.Ind J Ophthal 1997 (45:4); 234–235.Google Scholar
  31. 31.
    Biswas J, Madhavan N, George AE, Kumarasamy N, Solomon S. Ocular lesions in HIV positive children in South India.National Conference on Perinatal HIV & Pediatric AIDS. Dec 11–12,1999. Mumbai. Abstract.Google Scholar
  32. 32.
    Kumarasamy N, Solomon S, Madhivanan P, Kumar RB, Thiagarajan SP, Yesudian P. Dermatological manifestations among HIV patients in South India.Int J of Dermatology 2000 (39); 192–195.Google Scholar
  33. 33.
    Mintz M. Clinical comparison of adult and pediatric neuropathy and AIDS.Adv Neuroimmunol 1994 (4); 207–221.Google Scholar
  34. 34.
    De Cock KM. Guidelines for managing HIV/AIDS infection.BMJ 1997 (315); 1–2.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2003

Authors and Affiliations

  • Purnima Madhivanan
    • 1
  • S. N. Mothi
    • 2
    • 1
  • N. Kumarasamy
    • 1
  • T. Yepthomi
    • 1
  • C. Venkatesan
    • 1
  • John S. Lambert
    • 3
    • 1
  • Suniti Solomon
    • 2
    • 1
  1. 1.YR Gaitonde Center for AIDS Research and EducationVoluntary Health ServicesTamil NaduIndia
  2. 2.Asha Kirana Centre for AIDS Care and ResearchMysore
  3. 3.University of Maryland Institute of Human VirologyUSA

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