Comorbidities in Children and Adolescents with AIDS Acquired by HIV Vertical Transmission in Vitória, BrazilReport as inadecuate




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Background

Studying diseases associated with AIDS is essential for establishing intervention strategies because comorbidities can lead to death. The objectives were to describe the frequency of comorbidities and verify their distribution according to demographic, epidemiological and clinical data as well as to classify diseases in children and adolescents with AIDS in Vitória, Brazil.

Methods

A retrospective cohort study was conducted among children with AIDS, as defined according to the criteria established by the Ministry of Health, who acquired HIV via vertical transmission, were aged 0 to 18 years, and were monitored at a referral hospital from January 2001 to December 2011.

Results

A total of 177 patients were included, of whom 97 were female 55%. There were 60 patients 34% <1 year old, 67 patients 38% between the ages of 1 and 5, and 50 patients 28% ≥6 years of age included at the time of admission to the Infectious Diseases Ward. Regarding clinical-immunological classification, 146 patients 82.5% showed moderate-severe forms of the disease at the time of admission into the Ward, and 26 patients 14.7% died during the study. The most common clinical signs were hepatomegaly 81.62%, splenomegaly 63.8%, lymphadenopathy 68.4% and persistent fever 32.8%. The most common comorbidities were anaemia 67.2%, pneumonia-septicaemia-acute bacterial meningitis ABM 64.2%, acute otitis media AOM-recurrent sinusitis 55.4%, recurrent severe bacterial infections 47.4% and dermatitis 43.1%. An association between severe clinical-immunological classification and admission to the Ward for children aged less than one year old was found for several comorbidities p<0.001.

Conclusion

Delayed diagnosis was observed because the majority of patients were admitted to the Infectious Diseases Ward at ≥1 year of age and were already presenting with serious diseases. The general paediatrician should be alert to this possibility to make an early diagnosis in children infected with HIV.



Author: Sandra F. Moreira-Silva, Eliana Zandonade, Diana O. Frauches, Elisa A. Machado, Lays Ignacia A. Lopes, Lívia L. Duque, Polyana P

Source: http://plos.srce.hr/



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