Profile of HIV infected children: A hospital based study at Eastern Nepal

Objective: To investigate the clinical, laboratory, epidemiological profiles and outcome in human\udimmunodeficiency virus infected Nepalese children.\udMethods: This was a hospital based prospective study. Human immunodeficiency virusinfected children presenting to pediatric immunology clinic at BP Koirala Institute of Health\udSciences were enrolled and followed up.\udResults: Median age at diagnosis among 39 enrolled children was 58 months. All children\udacquired infection vertically. Unsafe sex (74.4%) and intravenous drug use (25.6%) were the\udmajor risk behaviors in fathers. At presentation, 20.8% children were asymptomatic, 54.0%\udwere malnourished, 41.0% were in WHO clinical stage 1, 17.9% were in stage 4, 74.4% were\udanemic, 17.9% had thrombocytopenia and median CD4 count was 543. Fever, lymphadenopathy,\udhepatosplenomegaly, skin eruptions and oral lesions were common presenting features (16.2%,\ud16.2%, 13.5%, 10.8%, and 8.1% respectively out of 74 features). Tuberculosis (16.0%), chronic otitis\udmedia (12.0%), scabies (10.7%), bacterial pneumonia (9.3%) and oropharyngeal candidiasis (6.7%)\udwere common opportunistic infections. Antiretroviral treatment was started in 18 (46.2%) cases at\udmedian age of 67 months. Median change in CD4 count at follow up was significantly different\udbetween the groups receiving and not receiving antiretroviral treatment (+192 vs. -72; P=0.045).\udConclusions: Infection in children is vertical. Undernutrition, anemia, fever, lymphadenopathy,\udhepatosplenomegaly, skin eruptions, and ear discharge are common presenting features.\udOpportunistic infections are common and tuberculosis is the most common opportunistic\udinfection followed by chronic ear infection, scabies, candidiasis and bacterial pneumonia. Timely\udantiretroviral treatment improves immune response