Children with human immunodeficiency virus infection admitted to a paediatric intensive care unit in South Africa
Date
2007
Authors
Rabie H.
de Boer A.
van den Bos S.
Cotton M.F.
Kling S.
Goussard P.
Journal Title
Journal ISSN
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Abstract
Background: Early data regarding the outcome of human immunodeficiency virus (HIV) - infected children in paediatric intensive care units (PICU) suggested mortality as high as 100%. Recent studies report mortality of 38%. Survival depends on the indication for admission. Objectives: To describe the prevalence, duration of stay, and outcome of HIV-infected patients in a single PICU over a 1-year period. Additional objectives included describing the indications for admission as well as the clinical and laboratory characteristics of HIV-infected infants and children requiring PICU admission. Method: Retrospective chart review of all children with serological proof of HIV admitted to PICU at Tygerberg Children's Hospital from 1 January to 31 December 2003. Results: Of the 465 patients admitted, 47 (10%) were HIV-infected. For HIV-infected children the median age on admission was 4 months. The median duration of stay was 6 days, significantly longer than for the non-HIV group (p = 0.0001). Fifty-seven percent had advanced clinical and immunological disease. Seventeen died in PICU and four shortly afterwards, poor PICU outcome was significantly associated with HIV status (p = 0.001). Lower total lymphocyte count (p = 0.004) and higher gamma globulin level (p = 0.04) were paradoxically the only findings significantly associated with survival. Acute respiratory failure (ARF) accounted for 76% of admissions, including Pneumocystis jiroveci in 38%. Fifty-one percent had evidence of cytomegalovirus infection. Conclusions: HIV-infected children requiring PICU can survive despite the lack of availability of antiretroviral therapy. © The Author [2007]. Published by Oxford University Press. All rights reserved.
Description
Keywords
antiretrovirus agent, immunoglobulin, acute respiratory failure, article, child, clinical feature, controlled study, cytomegalovirus infection, death, hospital admission, human, Human immunodeficiency virus infection, immunopathology, infant, intensive care, laboratory test, length of stay, lymphocyte count, major clinical study, medical record review, Pneumocystis jiroveci, prevalence, prognosis, retrospective study, serology, South Africa, survival, Cytomegalovirus Infections, HIV Infections, Humans, Infant, Intensive Care Units, Pediatric, Length of Stay, Pneumocystis jirovecii, Pneumonia, Pneumocystis, Prevalence, Respiratory Distress Syndrome, Adult, Retrospective Studies, South Africa, Survival Analysis
Citation
Journal of Tropical Pediatrics
53
4
53
4