HIV-1 infection among malnourished children in Butare, Rwanda.
In order to investigate the relationship between human immunodeficiency virus (HIV-1) infection and protein-energy malnutrition (PEM), all 101 malnourished children who were admitted to the Department of Pediatrics of the National University Hospital between February and July of 1989 (median age = 2.5 years), and who were accompanied by their mother were screened for HIV-1 antibody. Mothers were also screened and interviewed. Mother-child pairs were followed-up 2 years later to determine mortality and clinical status. Fourteen per cent of malnourished children were HIV-1 seropositive. Only one seropositive child had a seronegative mother. This child had a history of multiple blood transfusions and injections. Among children above 15 months of age, HIV-1 seropositivity was more common among marasmic children than among malnourished children presenting with oedema at admission to the hospital. Also, HIV-1 infection was found more frequently among chronically malnourished children (low height for age and weight for age) than among acutely malnourished children (low weight for height). Mortality during the 2-year follow-up was 75 per cent among HIV-1 seropositive children and 23 per cent among HIV-1 seronegatives (mortality density ratio = 6.2; 95 per cent confidence interval = 2.2-17.4). Severe, chronic PEM should always alert health workers to the possible diagnosis of pediatric AIDS, and its implications for treatment and prognosis.
Kurawige
J B
JB
Department of Pediatrics, School of Medicine, National University of Rwanda, Butare.
Gatsinzi
T
T
Kleinfeldt
V
V
Rehle
T
T
Bulterys
M
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications* / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D011502:Protein-Energy Malnutrition / Q000150:complications* / Q000401:mortality; D012432:Rwanda / Q000453:epidemiology