Clinically directed selective screening for HIV infection in hospitalized children.
BACKGROUND
As HIV infection presents with several manifestations, none of which is specific, several children are subjected to HIV testing. Very few studies have examined the issue of probability of HIV infection with a given clinical manifestation.


OBJECTIVE
To determine the probability of HIV infection when a child is hospitalized with at least one of the selected manifestations.


METHODS
Children aged 18 mo and above, admitted to a tertiary care center in Mumbai, India with chronic diarrhea, severe malnutrition, persistent cough, generalized lymphadenopathy, oral thrush, hepatomegaly, repeated common infections, generalized dermatitis, chronic parotid swelling, recurrent bacterial infection, disseminated tuberculosis and/ or Pneumocystis carinii pneumonia were enrolled in a prospective study after obtaining informed consent. They were subjected to HIV testing using WHO-UNAIDS strategy II. The data obtained was analyzed using the Statistical Package For Social Sciences (SPSS) software program.


RESULTS
Twenty-three (20 PERCENT) of the 115 children enrolled tested positive for HIV. The seropositivity rate for various features ranged from 9.1 PERCENT for chronic diarrhea to 83.3 PERCENT for chronic dermatitis. Oral thrush, generalized dermatitis and generalized lymphadenopathy were the significant independent clinical risk factors for predicting HIV seropositivity. The probability of HIV infection was higher in children who had higher number of risk factors present concomitantly


CONCLUSIONS
The probability of HIV infection in a child is dependent upon the nature and number of manifestations present.
Bavdekar
Sandeep B
SB
Department of Pediatrics, Seth GS Medical College and KEM Hospital, Parel,Mumbai 400 012, India. drsbavdekar@vsnl.com
Agarwal
Rinku
R
D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D015528:HIV Seroprevalence; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008403:Mass Screening; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors