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.
Department of Pediatrics, School of Medicine, National University of Rwanda, Butare.
J B
JB
Kurawige
T
T
Gatsinzi
V
V
Kleinfeldt
T
T
Rehle
M
M
Bulterys
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