Children with human immunodeficiency virus infection admitted to a paediatric intensive care unit in South Africa

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dc.contributor.authorRabie H.
dc.contributor.authorde Boer A.
dc.contributor.authorvan den Bos S.
dc.contributor.authorCotton M.F.
dc.contributor.authorKling S.
dc.contributor.authorGoussard P.
dc.date.accessioned2011-05-15T16:17:12Z
dc.date.available2011-05-15T16:17:12Z
dc.date.issued2007
dc.description.abstractBackground: 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.
dc.description.versionArticle
dc.identifier.citationJournal of Tropical Pediatrics
dc.identifier.citation53
dc.identifier.citation4
dc.identifier.issn01426338
dc.identifier.other10.1093/tropej/fmm036
dc.identifier.urihttp://hdl.handle.net/10019.1/14112
dc.subjectantiretrovirus agent
dc.subjectimmunoglobulin
dc.subjectacute respiratory failure
dc.subjectarticle
dc.subjectchild
dc.subjectclinical feature
dc.subjectcontrolled study
dc.subjectcytomegalovirus infection
dc.subjectdeath
dc.subjecthospital admission
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectimmunopathology
dc.subjectinfant
dc.subjectintensive care
dc.subjectlaboratory test
dc.subjectlength of stay
dc.subjectlymphocyte count
dc.subjectmajor clinical study
dc.subjectmedical record review
dc.subjectPneumocystis jiroveci
dc.subjectprevalence
dc.subjectprognosis
dc.subjectretrospective study
dc.subjectserology
dc.subjectSouth Africa
dc.subjectsurvival
dc.subjectCytomegalovirus Infections
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectInfant
dc.subjectIntensive Care Units, Pediatric
dc.subjectLength of Stay
dc.subjectPneumocystis jirovecii
dc.subjectPneumonia, Pneumocystis
dc.subjectPrevalence
dc.subjectRespiratory Distress Syndrome, Adult
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.subjectSurvival Analysis
dc.titleChildren with human immunodeficiency virus infection admitted to a paediatric intensive care unit in South Africa
dc.typeArticle
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