Outcome of symptomatic HIV-positive paediatric cases in Barbados - abstract

ABSTRACT

Fifteen symptomatic children comprising 9 males (60 per cent) and 6 (40 per cent) females, who tested positive for the human immunodeficiency virus (HIV) during a 6-year period, were studied. Patients were classified according to the Communicable Diseases Centre (CDC) epidemiological classification. The ages of patients ranged between 1 day and 7 years (mean 1.3 years). The mean incidence of cases was 3 per annum with a notable increase in annual cases during 1991. Nine cases (60 per cent) were aged < 1 year. Frequent symptoms/signs were lymphadenopathy in 7 patients (47 per cent), hepatosplenomegaly in (33 per cent) and failure to thrive (FTT), recurrent oral candidiasis, pneumocystis carinii pneumonia (PCP), and recurrent skin infections in each of 3 patients (20 per cent). Illnesses characteristic of HIV disease included oral candidiasis, Pneumocystis carinii pneumonia, and recurrent skin infections. Fifty-three per cent of cases were anaemic. Nine (60 per cent) patients had one or more hospitalizations. Seven patients (47 per cent), (mean duration 7.5 months after presentation), died during the period of study. Eleven mothers (73 per cent) tested positive for HIV, and 4 mothers were not tested (abandoned, died, or declined testing). Identified risk factors included contaminated blood transfusions in 2, prostitution in 1 mother, and i.v. drug use and bisexuality in 2 fathers. Eight patients were from low-income families and 6 from the mid-income group. Twelve cases were cared for by a parent up to the present time, 2 are orphans and 1 is abandoned. Data from this study illustrate that children with HIV infection in Barbados most frequently present with persistent adenopathy, hepatosplenomegaly, FTT, opportunistic infections and anaemia; the infection was exclusively acquired perinatally, and the majority of cases were cared for at home (AU)