Endoscopy findings in HIV-infected children from sub-Saharan Africa
Date
2009
Authors
Cooke M.L.
Goddard E.A.
Brown R.A.
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Abstract
Background: The causes of persistent gastro-intestinal symptoms in HIV-infected children from sub-Saharan Africa remain poorly documented. Methods: The clinical, radiological and endoscopic findings of all HIV-infected children who underwent upper GI endoscopy at Red Cross Children's Hospital, Cape Town, South Africa, from February 2003 to October 2005 were documented. Results: Twenty-six HIV-infected children underwent endoscopy; median age 1 year (range: 0.17-10.9 years). The majority had advanced HIV disease; 18 (69%) were WHO Stage 4; median CD4 10.7% (range: 1-39.8%). Presenting symptoms included persistent vomiting (18), dysphagia (4) and GIT bleed (6). Observational and histological findings showed poor correlation. Pathogens were identified in 10 children: cytomegalovirus infection in seven (two with cryptosporidium co-infection), Candida in two, Helicobacter pylori in one. Age and CD4 count were not associated with the pathogens. Endoscopy findings influenced clinical management in 21 (81%) cases. Conclusion: Upper-GI endoscopy identified a diverse spectrum of disease and provided information that would be clinically relevant to most HIV-infected children with upper gastro-intestinal symptoms. © The Author [2009]. Published by Oxford University Press. All rights reserved.
Description
Keywords
antiretrovirus agent, ganciclovir, omeprazole, Africa south of the Sahara, article, CD4 lymphocyte count, child, clinical article, clinical feature, controlled study, Cryptosporidium, cytomegalovirus infection, dysphagia, esophagitis, female, gastritis, gastrointestinal endoscopy, gastrointestinal hemorrhage, Helicobacter pylori, highly active antiretroviral therapy, histopathology, human, Human immunodeficiency virus infection, infant, male, vomiting
Citation
Journal of Tropical Pediatrics
55
4
55
4