scholarly journals Clinical spectrum of paediatric HIV infection in a tertiary care centre in South India

2018 ◽  
Vol 5 (4) ◽  
pp. 1348
Author(s):  
Santhosh Kumar K. K. ◽  
Narayanappa D. ◽  
Ravi M. D. ◽  
Jagadish Kumar K.
Keyword(s):  
Hiv Infection ◽  
Vertical Transmission ◽  
Opportunistic Infections ◽  
Nutritional Assessment ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Pediatric Hiv ◽  
Hiv Encephalopathy ◽  
Paediatric Hiv

Background: The global burden of paediatric HIV and acquired immune deficiency syndrome (AIDS) remains a challenge for healthcare workers around the world, particularly in developing countries. The objective of this study is to describe the spectrum of HIV infection in children including the mode of transmission, clinical manifestations and opportunistic infections associated with HIV infection.Methods: Confirmed HIV seropositive children aged between 18 months to 19 years admitted to paediatric ward of JSS hospital, Mysore during two-year period were enrolled in this prospective observational study. Detailed history, socio-demographic characteristics and clinical manifestations were recorded in the predesigned performa. Nutritional assessment, complete physical, systemic and neurological examination was performed at the time of admission and was supplemented with ancillary investigations. Patients were correlated with modified WHO clinical case definition for AIDS and categorized as per revised CDC NABC classification of pediatric HIV infection.Results: Forty HIV-infected children were enrolled: with mean age of 4.5 years. Vertical transmission was the predominant mode of HIV transmission (97.5%). Most of the children were severely symptomatic belonging to category-C of NABC classification. Common clinical manifestations noted were failure to thrive (45%), recurrent respiratory infections (42%), bacterial skin infection (36%), recurrent otitis (42.5%), papulo-pruritic dermatitis (22%), hepatosplenomegaly (85%), lymphadenopathy (45%) and HIV encephalopathy (52%). The common opportunistic infections observed were pulmonary tuberculosis (45%), recurrent diarrhoea (35%), oral candidiasis (30%). The rare presentations of HIV noted were chronic thrombocytopenia and a case of dilated cardiomyopathy.Conclusions: Vertical transmission was the major route of HIV infection. HIV encephalopathy was more common among severely affected children. Tuberculosis was the commonest opportunistic infection.

Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count

2020 ◽  
pp. 1-8
Author(s):  
Archana Mishra ◽  
Narendra Nath Soren ◽  
Sristi Ganguly
Keyword(s):  
Opportunistic Infections ◽  
Nutritional Assessment ◽  
Clinical Stage ◽  
Clinical Manifestations ◽  
Cd4 Count ◽  
Pediatric Hiv ◽  
Clinical Staging ◽  
Categorical Variables ◽  
Chi Square ◽  
Cd4 Counts

Aims: To study the clinical profile of HIV infected children and correlate them with the CD4 count at the time of presentation. Study Design: Hospital based observational study Place and Duration of Study: ART centre of SCBMCH and Department of Pediatrics, SVPPGIP, Cuttack, Odisha during the period October 2017 to September 2019. Methodology: All children aged between 1.5 to 15 years who were confirmed to be HIV positive by ELISA or immunocomb II, either at present or past were included in the study. They were subjected to CD4 count testing, along with nutritional assessment and screened for opportunistic infections, apart from their socio-demographic details. All quantitative variables including age, weight, height, were compared by unpaired t-test. Categorical variables like sex mode of transmission were compared by chi-square test. Variables like clinical staging, immunological staging and CD4 counts were measured at presentation and analyzed with repeated ANOVA at 5% level of significance to allow for multiple comparisons. P<0.05 was considered significant and inferences were drawn. Results: Out of 103 cases, majority belonged to age 4- 7 years and 59.2% were malnourished. 24.3% were asymptomatic, with the most common clinical features noted were fever (65%), cough (47.8%), recurrent diarrhoea (41.8%) and weight loss (40.8%). The incidence of opportunistic infections was 24.3%, with tuberculosis (40%) and herpes zoster (36%) leading the list. Most cases (37.87%) came under WHO clinical stage-III. A significant correlation was found between CD4 count and age, WHO clinical staging, opportunistic infections in the population. Lower CD4 counts were associated with younger age, lower staging and less risk for symptoms and infections. Conclusion: CD4 count is a reliable market to assess the staging and risk for opportunistic infections in pediatric HIV and thus can be used as screening tool for complications/ deterioration in the child, for better management.

Perinatal Human Immunodeficiency Virus (HIV) Testing

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 791-794
Author(s):  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Vertical Transmission ◽  
Task Force ◽  
Perinatal Transmission ◽  
Pediatric Hiv ◽  
Number Of Children ◽  
Perinatal Hiv ◽  
Seroprevalence Data ◽  
Immunodeficiency Virus

PERINATAL INFECTIONS The primary route of human immunodeficiency virus (HIV) infection in infants is vertical transmission from HIV-infected mothers. This is of particular concern as the number of infected women and the number of children infected by perinatal transmission continue to increase rapidly. The number of perinatally acquired acquired immunodeficiency syndrome (AIDS) cases increased 17% in 1989 and 21% in 1990. Similarly, the number of heterosexually acquired AIDS cases increased 27% in 1989 and 40% in 1990. There is evidence that vertical transmission of HIV can occur in utero (congenital/transplacental, similar to rubella),1,2 in the postpartum period (breast-feeding), and perhaps in the intrapartum period (similar to hepatitis B).3 The relative frequency and efficiency of transmission during each of these periods remains uncertain. The best estimates of vertical transmission from an HIV-seropositive mother to the fetus range from 12.9% to 39%4-6 Although the risk of transmission appears to be increased in women who are symptomatic, this point is still unclear.5 Preliminary information suggests that the presence of high levels of high-affinity/avidity antibodies to specific epitopes of the gp 120 of HIV may be protective and may decrease or prevent vertical transmission,7-10 although others have not been able to confirm this finding.11 More detailed information on perinatal HIV infection,12 and infection control13 in pediatric HIV infection is available in previously published statements from the AAP Task Force on Pediatric AIDS. SEROPREVALENCE Anonymous seroprevalence data from newborn specimens are being collected in 44 states, Puerto Rico, and the District of Columbia. In some states, seroprevalence data are available by metropolitan area and/or by hospital of birth.

scholarly journals Seroprevalence of human immunodeficiency virus infection among tuberculosis patients at tertiary care combined hospital

2015 ◽  
Vol 3 (3) ◽  
pp. 130-135
Author(s):  
Rakesh Basavareddy ◽  
Asha Basavareddy ◽  
Shimoga Laxman Ravi ◽  
Bilagumba Ramu Kiran ◽  
Gadwalkar R. Srikant
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Clinical Features ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Chi Square ◽  
Cross Sectional ◽  
Hiv Seroprevalence ◽  
Adequate Knowledge ◽  
Immunodeficiency Virus

Abstract Background and Objectives: Tuberculosis (TB) and the human immunodeficiency virus (HIV) infection have reached epidemic proportions in our country. This study was undertaken to know the seroprevalence of HIV infection among TB patients and to evaluate the various clinical features of TB in seropositive and seronegative patients. This study was undertaken in Vijayanagara Institute of Medical Sciences, Bellary. It was cross-sectional comparative observational study conducted from December 2010 to May 2012. Materials and Methods: A total of 100 consecutive patients diagnosed with TB satisfying inclusion criteria were selected for the study. All patients went through a detailed evaluation along with testing for HIV seroprevalence. Chi-square and Student’s t-tests used to find the significance between two groups. Results: The overall HIV seroprevalence among TB patients was 8%. Seroprevalence was highest in the age group between 31 and 40 years at 29.41% (odds ratio [OR] = 11.11, P = 0.003). It was found that seropositive TB patients were more likely to present with significant weight loss (OR = 19.25, P= 0.000), and have lymphadenopathy OR = 13.24, P = 0.002) and oral candidiasis (OR = 49.44, P = 0.000) on examination. Bilateral chest radiographic involvement (OR = 57.40, P = 0.000) and the disseminated variety of the disease (OR = 29.67, P = 0.001) are also more probable. Conclusions: Human immunodeficiency virus seroprevalence is quite high among TB patients in Bellary. During the evaluation of TB patients, the possibility of HIV co-infection should be kept in mind, and thus adequate knowledge of the likely clinical features is absolutely necessary.

Pediatric HIV infection: A review of epidemiology, clinical manifestations, and current intervention

1996 ◽  
Vol 8 (3) ◽  
pp. 179-210
Author(s):  
Deborah A. Pearson ◽  
Marilyn D. Doyle ◽  
Larry K. Pickering ◽  
Juliana Ortegon
Keyword(s):  
Hiv Infection ◽  
Clinical Manifestations ◽  
Pediatric Hiv

scholarly journals Frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure

2020 ◽  
Vol 7 (7) ◽  
pp. 1165
Author(s):  
Narendra Singh ◽  
Lalit Kumar ◽  
Desh Nidhi Singh ◽  
Vipin Kumar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Opportunistic Infection ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Institute Of Medicine ◽  
Post Graduate Institute ◽  
Centre Hospital ◽  
Tubercular Lymphadenitis

Background: There is so many opportunistic infection is present in PL HIV patient when patient immunity disturbed and their CD4 count decreased .this study was conducted for frequency of opportunistic infection in PL HIV and its role in monitoring of ART 1 failure. Aims and objective was to study the frequency of opportunistic infection in PL HIV and its role in monitoring of ART1 failure.Methods: This study was conducted in ART plus centre K.P.S. Post Graduate Institute of Medicine (G.S.V.M. Medical College, Kanpur) tertiary care teaching hospital and is clinical (assessment with investigation) continuous longitudinal, prospective and retrospective, observational, single centre hospital based study at ART Centre, Kanpur and considered All the patient on 1st line ART treating attending in centre were screened for treatment failure decided by SACEP from 2016 to 2018.Results: In this study there was opportunistic infection present that maximum in oral candidiasis but overall tuberculosis is maximum that is considered pulmonary tuberculosis, extra pulmonary tuberculosis, tubercular lymphadenitis and tubercular pericarditis, Abdominal knocks, TBM. LRTI and chronic diarrhea is also present. The male and rural area are more having opportunistic infections and all are have CD4 count 100 to 200 micrometer /Litre.Conclusions: The opportunistic infection mostly are oral candidiasis and tuberculosis, present in CD4 count in the range of 100-200 /ml.it is the indication of ART failure during treatments.

scholarly journals Clinical and Socio demographic profile of attendees at ART centre in a tertiary care hospital in Mangalore, India

2015 ◽  
Vol 6 (5) ◽  
pp. 61-65
Author(s):  
U.B. Nayak ◽  
S. Lenka ◽  
B. Achappa
Keyword(s):  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Local Context ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Heterosexual Contact ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Hiv Aids

Introduction: India has the third largest number of people living with HIV/AIDS. There is a need to study the profile of patients who come to ART centers and link their clinical and socio-demographic variables in the management. Moreover, it is important to understand the presentation of HIV disease in the local context and culture. The present study is aimed at identifying the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection at an ART centre of Government Wenlock hospital, situated in Karnataka state of India. Materials and Methods: In this study 102 HIV patients attending the HIV clinic were enrolled and they were followed for a period of one year with relevant investigations.Results: Of 102 patients 69 were males and 33 were females.The mean age of the study subjects at the time of diagnosis was 38.06. Heterosexual contact was the commonest mode of transmission in96 (94.12%) patients. History suggestive of a risk factor for HIV transmission could not be elicited in 4 (3.92%) patients. Fever (71.5%), weight loss (62.74%), cough (51.96%) and chronic diarrhea (43.9%) were the common presenting symptoms. The most common opportunistic infection was oral candidiasis (66.67%) followed bytuberculosis (22.54%) and pneumocystis pneumonia (13.72%). Significant number of patients (30.37%) developed Zidovudine induced anemia and females were more prone for Zidovudine induced anemia as compared to males. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusion: Majority of patients were of low socioeconomic status and in productive age group with heterosexual contact being commonest mode of transmission.Significant number of patients developed Zidovudine induced anemia and females were more prone. DOI: http://dx.doi.org/10.3126/ajms.v6i5.11622Asian Journal of Medical Sciences Vol.6(5) 2015 61-65

Clinical Manifestations of HIV Infections

1987 ◽  
Vol 32 (4) ◽  
pp. 101-107 ◽  
Author(s):  
D.H. Kennedy
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Hiv Infections ◽  
Underlying Disease ◽  
Hiv Disease ◽  
Important Target ◽  
Target Organs ◽  
The Brain

The wide clinical spectrum of HIV infection is reflected in the new CDC classification. Presentations range from acute infection, asymptomatic carriage and persistent lymphadenopathy through constitutional upset and neurological disease to the opportunistic infections and cancers of AIDS. AIDS is an enigmatic disease which presents special clinical diagnostic and management problems. Although any system may be affected the lungs and the brain are the most important target organs. Though the underlying disease is currently untreatable, many of the complications of AIDS are amenable to prompt therapy. Seropositive patients should be monitored to detect early signs of significant HIV disease. Skilled counselling about the avoidance of co-factors which may potentiate HIV infection, is important.

Opportunistic Infections in Pediatric HIV Infection: A study of 74 Autopsy Cases from Latin America: The Latin American AIDS Pathology Study Group

1997 ◽  
Vol 17 (4) ◽  
pp. 569-576
Author(s):  
Ricardo Drut ◽  
Virginia Anderson ◽  
M. Alba Greco ◽  
Carmen Gutiérrez ◽  
Beatriz de León-Bojorge ◽  
...  
Keyword(s):  
Latin America ◽  
Hiv Infection ◽  
Latin American ◽  
Opportunistic Infections ◽  
Pediatric Hiv ◽  
Study Group

scholarly journals Mucocutaneous infections in HIV positive patients attending a tertiary care institution: a descriptive study

2017 ◽  
Vol 3 (2) ◽  
pp. 175
Author(s):  
Neethu Haridas ◽  
Kunnummal Muhammed ◽  
Sarita S.
Keyword(s):  
Hiv Infection ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Herpes Genitalis ◽  
Hiv Positive ◽  
Female Ratio ◽  
Sexually Transmitted ◽  
Care Institution ◽  
Tertiary Care Institution

<p><strong>Background: </strong>AIDS is characterized by the waning of body’s immunity leaving the victim to the multitude of life threatening opportunistic infections, neurological disorders or malignancies. Dermatologic manifestations occur in more than 90% of patients with HIV infection most often due to infections.  The awareness of the varied patterns of these skin lesions would help in early diagnosis and management of these in HIV infection, which in turn reduce the morbidity and improve quality of life.<strong></strong></p><p><strong>Methods: </strong>Observational study from 1<sup>st</sup> April 2012 to 31<sup>st</sup> March 2013 in a tertiary care institution of North Kerala. HIV positive patients attending sexually transmitted infection clinic of Dermato venereology department, anti-retroviral treatment clinic (ART clinic) and infectious diseases ward of Department of Medicine of a tertiary care centre were examined after consent for mucocutaneous infections.  <strong></strong></p><p><strong>Results: </strong>The study population comprised of 206 HIV infected patients with mucocutaneous infections. The male to female ratio was 2.07:1. Most of the affected belong to 30-50 years age group. Majority were manual laborers(49.3%) and in stage3 HIV disease. 107 patients had CD4 Count below 350 at the time of study(51.9%) whereas 40 cases (19.4%) had CD4Count above 500.<strong> </strong>Most common mucocutaneous infection was oral candidiasis (51%), followed by onychomycosis (16.5%). Out of 29 patients with dermatophytosis majority had tinea cruris (18 patients). Bacterial was second commonest infection. Only 3 patients had tuberculoid leprosy, one with type 1 reaction.<strong> </strong>Common viral infection was herpes zoster followed by herpes genitalis and conyloma accuminata. 11 patients had verruca vulgaris, one with extensive lesions.<strong> </strong>Out of 206 patients 28 had sexually transmitted infections (STIs) other than HIV, herpes genitalis being the commonest. Syphilis observed in 4 patients (1.9%). 162 patients (78.6%) were on HAART. The response to treatment was better in patients with CD4 Count above 500cells/mm<sup>3</sup>. <strong></strong></p><p><strong>Conclusions:</strong>Oral candidiasis, onychomycosis, pyoderma and ulcerative STIs were noted in significant number of HIV infected individuals. These were more common in those with CD4Count below 300 cells/ mm<sup>3</sup>. <sup>.</sup>Those patients with CD4 Count above 500 cells/ mm<sup>3</sup> responded well to treatment. </p>

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