Abstract
Objectives
(i) To study the clinical and immunological profile of HIV infected children attending the ART centre; (ii) To correlate CD4 count with clinical staging at diagnosis; and, iii) To study the clinical and immunological response to antiretroviral treatment.
Setting
Antiretroviral therapy (ART) centres of two tertiary care hospitals of Delhi.
Patients
100 children attending the centres between December 2008 to June 2009.
Methods
The clinical features, immunological profile (CD4 count) and response to ART were recorded in a structured proforma.
Design
Prospective follow-up.
Results
Average age of enrolled children was 6.24 y (range 1–14 years) and mode of transmission was parent to child in 92%. Most common clinical presentation was fever (83%), cough (50.8%) and diarrhea (38.9%). Tuberculosis was the most common opportunistic infection seen in 11% of children. 59% of enrolled children were malnourished. Antiretroviral treatment (ART) was initiated in 33 children. Children who were initiated on ART had a significant improvement in both clinical and immunological staging at the 6 months follow up. Immunological response (rise in CD4 count) to ART was better in children with lesser degree of immunosuppression. The measure of agreement between the clinical and immunological stage at presentation was poor.
Conclusions
Baseline CD4 counts rather than clinical staging can be a primary determinant for initiation of antiretroviral treatment in HIV infected children.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Department of AIDS Control, Ministry of Family Welfare, Government of India. Annual Report 2008–2009. Available from: http://nacoonline.org/upload/Publication/Annual_Report_NACO_2008-09.pdf. Accessed on 27 February, 2010.
Asnake S, Amsalu S. Clinical manifestations of HIV/AIDS in children in Northwest Ethiopia. Ethiop J Health Dev. 2005;19:24–28.
Shah D, Gupta P, Ghai OP. Nutrition and health. In: Gupta P, Ghai OP. Eds. Textbook of Preventive and Social Medicine. 2nd ed. New Delhi: CBS Publisher and Distributors; 2004. p. 100–154.
Shah N. Clinical diagnosis of pediatric HIV. In: Shah I, Shah NK, Manglani M. eds. IAP Speciality Series on Pediatric HIV. 1st ed. Mumbai: Indian Academy of Pediatrics; 2007. p. 21–29.
Shah I. Antiretroviral therapy. In: IAP Speciality Series on Pediatric HIV. Shah I, Shah NK, Manglani M editors. 1st ed. Mumbai: Indian Academy of Pediatrics; 2007. p. 63–69.
Agarwal D, Chakravarty J, Sundar S, Gupta V, Bhatia BD. Correlation between clinical features and degree of immunosuppression in HIV infected children. Indian Pediatr. 2008;45:140–143.
Padmapriyadarshini C, Poornagangadevi N, Chadrasekaran K, Subramanian S, Thiruvalluvan C, Bhavani PK, et al. Prevelance of underweight, stunting, and wasting among children infected with human immunodeficiency virus in south India. Int J Pediatr. 2009; 2009:837627.
Hamadache D. HIV testing guidelines for children of confirmed or suspected HIV positive parents. Available from http://www.chiva.org.uk/health/guidelines/hivtesting. Accessed on 27 February, 2010.
Natu SA, Daga SR. Antiretroviral therapy in children: Indian experience. Indian Pediatr. 2007;44:339–343.
Shah I. Correlation of CD4 count, CD4% and HIV viral load with clinical manifestations of HIV in infected Indian children. Ann Trop Paediatr. 2006;26:115–119.
Lawn SD, Myer L, Bekker LG, Wood R. CD4 cell count recovery among HIV-infected patients with very advanced immunodeficiency commencing antiretroviral treatment in sub-Saharan Africa. BMC Infect Dis. 2006;6:59.
Universal Access to AIDS Treatment: Targets and Challenges. Available from http://www.avert.org/universal-access.htm. Accessed on 27 February, 2010.
Pattanapanyasat K, Thakar MR. CD4+ T cell count as a tool to monitor HIV progression and anti retroviral therapy. Ind J Med Res. 2005;121:539–549.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gomber, S., Kaushik, J.S., Chandra, J. et al. Profile of HIV infected children from Delhi and their response to antiretroviral treatment. Indian Pediatr 48, 703–707 (2011). https://doi.org/10.1007/s13312-011-0117-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-011-0117-7