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Disease in children infected with HIV in Abidjan, Cote d'Ivoire.
Lucas SB; Peacock CS; Hounnou A; Brattegaard K; Koffi K; Honde M; Andoh
August 30, 1996
BMJ. 1996 Feb 10;312(7027):335-8. Unique Identifier : AIDSLINE

OBJECTIVE--To document the range of disease in African children infected with HIV. DESIGN--Necropsy results in consecutive children aged 1 month or more who were HIV positive and in children who were HIV negative for comparison; IgA western blots on serum samples from children under 2 years of age who were positive for HIV-1 to test the validity of routine HIV serology. SETTING--Largest hospital in Abidjan, Cote d'Ivoire. SUBJECTS--78 children who were HIV positive and 77 children who were HIV negative on whom a necropsy was performed; their median ages at death were 18 and 21 months respectively. 36 HIV positive children and 29 HIV negative children were 1-14 months old; 42 HIV positive and 48 HIV negative children were > or = 15 months old. MAIN OUTCOME MEASURES--Cause of death and prevalence of diseases confirmed pathologically. RESULTS--Respiratory tract infections were more common in HIV positive than in HIV negative children (73 (94%) v 52 (68%); P < 0.05), and were aetiologically heterogeneous. Pneumocystis carinii pneumonia was found in 11 out of 36 (31%) HIV positive children aged < 15 months, but in no HIV negative children. Among older children measles was more common in HIV positive children (8/42 (19%) v 2/48 (4%); P < 0.06). Pyogenic meningitis was present in similar proportions of HIV positive and HIV negative children aged < 15 months (7/36 (19%) and 7/29 (24%)). In HIV positive children tuberculosis (1/78), lymphocytic interstitial pneumonitis (1/78), and HIV encephalitis (2/78) were rare. CONCLUSIONS--There is greater overlap between diseases associated with HIV infection and other common health problems in African children than there is in adults. Compared with adults, HIV positive children had a high prevalence of P carinii pneumonia and a low prevalence of tuberculosis. Measles, but not malaria, was associated with HIV infection.

Autopsy AIDS Dementia Complex/EPIDEMIOLOGY AIDS-Related Opportunistic Infections/EPIDEMIOLOGY Cause of Death Cote d'Ivoire/EPIDEMIOLOGY Human HIV Infections/COMPLICATIONS/*MORTALITY HIV Seronegativity HIV Seropositivity/COMPLICATIONS Infant Malaria/EPIDEMIOLOGY Measles/EPIDEMIOLOGY Meningitis/EPIDEMIOLOGY Prevalence Respiratory Tract Infections/EPIDEMIOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE