Publication:

Opportunistic infections in HIV infected children and its correlation with CD4 count

Background HIV infected children usually have higher viral load, weaker immune system, variable latency period, fewer opportunistic infections and fewer medicines approved for management. Knowledge of the clinical profile in HIV infected children will help in better understanding of the disease and management. The present study was aimed to study the clinical presentation, opportunistic infections, WHO clinical stage, nutritional status and its correlation with CD4 count.

Methods 50 children below 14 years of age and seropositive for HIV were included in this study and were categorized into WHO clinical stages. They were further classified based on CD4 count values in accordance with WHO classification of immunodeficiency.

Results In the study 30% of children were in the age group of 4 to 7 years. The mean age of presentation was 7.12 years. 56% of children presented with WHO clinical stage III and 30% with stage IV at first visit. Vertical transmission was the predominant mode of transmission. Anaemia (48%), fever (42%) and cough (34%) were common symptoms. Pulmonary tuberculosis (28%) was the most common opportunistic infection seen at mean CD4 count of 267±5.37.

Conclusions The manifestations of HIV infection in children mimic a number of other illnesses. Anaemia, fever and cough were the common presenting clinical features. Tuberculosis is the most common opportunistic infection in HIV infected children. As WHO clinical stage and grade of PEM increases CD4 count decreases. CD4 count is a reliable marker of disease progression in HIV infected children.