Spectrum of opportunistic infections in HIV infected children in North India

Abstract

Introduction: Human Immunodeficiency Virus adversely affects the immune system of the body, making a person vulnerable to variety of infections. Usually benign micro organisms become virulent and cause serious illnesses. Such opportunistic infections are very common in HIV infected children. If they are not diagnosed and treated in time they may prove fatal. The pattern of opportunistic infections are changing with time and place. To study the newer pattern of opportunistic infection in HIV infected children, this study was undertaken.

Methods: 140 children of both sexes between age 18 months to 15 years, diagnosed HIV positive as per NACO HIV testing guidelines, were included in this study. They were examined, investigated and classified into clinical and immunological staging as per WHO classification. They were investigated for opportunistic infections.

Result: Different kinds of skin involvement including scabies, papular pruritic eruptions, seborrhoic dermatitis, pyoderma, herpes zoster, molluscum contagiosum, fungal infections were noted in 47% children. Oropharyngeal candidiasis was also common. Recurrent respiratory tract infection, recurrent diarrhea, urinary tract infection, CSOM, parotid involvement was seen in majority of children. Over all, bacterial infection was seen in 36.4% children, followed by fungal infection in 18.5%, viral infection in 14.3% and tubercular infection in 10% respectively. Several studies have reported tuberculosis as the most common opportunistic infection in HIV infected children, but contrary to this, tuberculosis was the fourth commonest opportunistic infection in our study. Recurrent bacterial infections were the commonest one. Pneumocystis Carinii Pneumonia (PCP), the hallmark of AIDS defining illness in developed world, is not so common in our set up. We found only one probable case of PCP in our study.