SOME EARLY OBSERVATIONS ON HIV-INFECTION IN CHILDREN AT KING-EDWARD-VIII-HOSPITAL, DURBAN

  • 3 November 1990
    • journal article
    • research article
    • Vol. 78  (9) , 524-527
Abstract
Nine black children aged between 3 months and 30 months of age, with human immunodeficiency virus type I (HIV-I) infection are described to draw the attention of health professionals in southern Africa to special clinical characteristics useful for recognising this problem, which has many shared features with common diseases of infancy and childhood in the Third World. The main presenting complaints were chronic cough and persistent diarrhoea and vomiting. These children frequently had diarrhoea (8 of 9 patients), mucocutaneous candidiasis (8), pneumonia (7), hepatosplenomegaly (9), significant lymphadenopathy (5) and wasting (5). All were infected by common bacteria, such as Gram-negative organisms, Mycobacterium tuberculosis and Campylobacter jejuni, or by opportunistic infections such as Candida or cytomegalovirus (CMV), or by both bacterial and opportunistic organisms. A raised total serum globulin level, anaemia, lymphopenia and a cerebrospinal fluid (CSF) pleocytosis were frequent findings. Incomplete data on parental HIV status suggest perinatal transmission. Three of the children were HIV-antigen positive. The diagnosis of full-blown acquired immunodeficiency syndrome (AIDS), using the stringent Centers for Disease Control criteria, is difficult in our situation because of limited diagnostic resources; however, using these criteria, and the clinical case definition for AIDS recommended by World Health Organisation, it is thought that probably 4 of these children could be considered as having AIDS. Any child with an elevated serum globulin level, CMV infection, an unexplained abnormal CSF, an unusual or unresponsive form of tuberculosis, long-standing symptoms of common childhood illness and found to have diarrhoea, pneumonia, mucocutaneous candidiasis, hepatosplenomegaly, lymphadenopathy and wasting should be evaluated for the presence of HIV infection.