Otorrhoea is a marker for symptomatic disease in HIV-infected children.
BACKGROUND
Chronic otorrhoea occurs commonly in HIV-infected children. However, there are few data on incidence and severity.


OBJECTIVE
To document the prevalence of otorrhoea in the clinic attendees.


METHODS
A retrospective chart review was done of all HIVI infected children seen at the Family Clinic for HIV from 1 February 1997 to 31 December 2001, a period preceding widespread availability of antiretrovirals. Otorrhoea was classified into two groups, viz. group 1 (mild): an episode lasting less than 1 month, and group 2 (severe): an episode lasting more than 1 month or more than 1 episode of otorrhoea. The clinical and immune stages of the children were noted.


RESULTS
Of 326 children seen during the study period, 104 (32%) had otorrhoea. Forty-five (13.8%) had mild and 59 (18.1%) severe otorrhoea. Two hundred and eighty-eight (88.6%) had either Centers for Disease Control stage B or C disease. The median CD4 percentage in children with otorrhoea was 17.5% (8.3-23%) versus 21% (14-28%) in those without otorrhoea (p=0.004). The odds ratio (OR) of children in stage B or C not having severe otorrhoea was 0.1 (0.01 - 0.72, p = 0.013). The OR for immune class 2 or 3 without severe otorrhoea was 0.39 (0.18 - 0.85, p = 0.021).


CONCLUSIONS
Otorrhoea contributes to the morbidity of HIV infection in children. It is a marker for symptomatic disease and CD4 depletion and should be included in clinical classifications.
Karpakis
J
J
Children's Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child Health, Tygerberg Children's Hospital and Stellenbosch University, W Cape.
Rabie
H
H
Howard
J
J
Janse van Rensburg
A
A
Cotton
M F
MF
D002558:Cerebrospinal Fluid Otorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology
D015483:HIV Antibodies; D012367:RNA, Viral