Clinical profile of hospitalized HIV-infected children in Bangladesh, a low-HIV-prevalence country. (May 2014)

• Record Type: Journal Article
• Authors: Shahrin, Lubaba; Leung, Daniel T.; Matin, Nashaba; Kawser, Chowdhury Ali; Pervez, Mohammed Moshtaq; Chisti, Mohammod Jobayer
• Is Part Of: Paediatrics and international child health. Volume 34:Number 2(2014:May)
• Page Start: 133
• Page End: 137
• Publication Date: 2014-05
• Subjects: Pediatrics -- Developing countries -- Periodicals; Children -- Health and hygiene -- Developing countries -- Periodicals; Children -- Diseases -- Developing countries -- Periodicals; 618.920009172405
• DOI: 10.1179/2046905513Y.0000000100
• Languages: English
• ISSNs: 2046-9047

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>Bangladesh has a low HIV prevalence and data on the risk factors and clinical presentation of HIV-infected children are lacking.</p> </sec> <sec> <title>Objective:</title> <p>To describe the clinical characteristics of hospitalized HIV-infected children in Bangladesh and determine the factors associated with a low CD4 count.</p> </sec> <sec> <title>Methods:</title> <p>An anonymous, retrospective review was undertaken of the medical records of all patients admitted to the HIV unit of the iccdr, b Dhaka Hospital between February 2009 and July 2012. Demographic, clinical and laboratory data were extracted from the electronic medical record system. HIV-infected children with a low absolute CD4 count (<200 cells/μl) were compared with HIV-infected children with a CD4 count ≧200 cells/μl.</p> </sec> <sec> <title>Results:</title> <p>Of 266 HIV-infected patients, 24 were children (9%), 13 (54%) of whom were male. Ages ranged from 2 to 17 years (median 7). Of the 21 (88%) children who acquired the infection by vertical transmission, median age at diagnosis was 5·2 years, and the parents of 19 (79%) reported a history of external migration. Children commonly presented with prolonged fever (<italic>n</italic> = 14, 58%), recurrent cough (<italic>n</italic> = 14, 58%), failure to thrive (<italic>n</italic> = 11, 46%) and recurrent diarrhoea (<italic>n</italic> = 4, 17%). Six (25%) patients had tuberculosis, four (16·7%) had herpes zoster and four (16·7%) were diagnosed with <italic>Pneumocystis jirovecii</italic> pneumonia. One child died during hospitalization. Children with a low CD4 count (<200 cells/μl) more often had severe wasting (95% CI 1·2–453·97) and severe under-nutrition (95% CI 1·39–196·25) than those with a higher CD4 count*.</p> </sec> <sec> <title>Conclusion:</title> <p>The majority of HIV-infected children presenting to an inpatient speciality ward in Dhaka acquired HIV through vertical transmission, and most of the parents had a history of external migration. Further studies are needed to determine the optimal strategy for preventing mother-to-child transmission and for early identification and treatment of HIV-infected children in this low-prevalence country.</p> </sec> </abstract>