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- Title
Children with Human Immunodeficiency Virus Infection Admitted to a Paediatric Intensive Care Unit in South Africa.
- Authors
Helena Rabie; Anna de Boer; Suzanne van den Bos; Mark F. Cotton; Sharon Kling; Pierre Goussard
- 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 Childrens 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.
- Publication
Journal of Tropical Pediatrics, 2007, Vol 53, Issue 4, p270
- ISSN
0142-6338
- Publication type
Academic Journal
- DOI
10.1093/tropej/fmm036