Clinical Features Directed Screening for HIV Infection among Children attending an Urban Referral Centre

INTRODUCTION: EPIDEMIOLIOGY : 1. 38.6 million - HIV infection world over, 2.3 million, i.e. 5.9 % - children <15 years of age 2. In 2007- 5,40,000 children were born with HIV infection transmitted from their infected mothers 3. 90% - sub-saharan Africa & remaining in Asia , mainly in India 4. Estimated total no. of HIV infection in India : a) 3.97 million – 2001 b) 5.1 million – 2003 c) 5.134 million – 2004 d) 6.13 million - 2010 5. No. Of children living with HIV in India – 0.17 million (UNAIDS report 2004) to 0.24 million(NACO estimate). 6. India – 3 zones 7. High prevalence - HIV prevalence in ANC mothers > 1% 8. Medium prevalence - < 1% but in high risk population in STI clinics >20% 9. Low prevalence - <1% & in high risk < 20% AIM OF THE STUDY: To determine the probability of HIV infection when a child is presenting with, a) One of the selected clinical features and b) in combinations. DISCUSSION: Human immunodeficiency virus(HIV) is estimated to be constituted by 3 to 5% by paediatric age group less than 15 years amondg all cass reported. The registered paediatric cases at various institutions are far below the estimated. 38.6 million - HIV infection world over, 2.3 million, i.e. 5.9 % - children <15 years of age. In 2007- 5,40,000 children were born with HIV infection transmitted from their infected mothers. 90% - subsaharan Africa & remaining in Asia , mainly in India Estimated total no. of HIV infection in India 3.97 million – 2001,5.1 million – 2003, 5.134 million – 2004, 6.13 million – 2010, No. Of children living with HIV in India – 0.17 million (UNAIDS report 2004) to 0.24 million (NACO estimate). In India, it is divided into 3 zones. High prevalence - HIV prevalence in ANC mothers > 1%. Medium prevalence - < 1% but in high risk population in STI clinics >20%. Low prevalence - <1% & in high risk < 20% High prevalence – (6) Maharashtra, Karnataka, Tamilnadu, Andhrapradesh, Manipur, Nagaland. Medium prevalence – (2) Gujarat, West Bengal Low prevalence – rest of states. National average of HIV prevalence in AN mothers – 0.7% MTCT- 15 to 30%- non-breastfeeding population, 30 to 45% - breastfeeding population. CONCLUSION: 1.Clinical profile of HIV in our study correlates with other literature. 2. In our study, the following clinical features emerged a independent predictors of HIV infection. a) Fever more than one month b) Very low weight or severe malnutrition c) Recurrent pneumonia d) Persistent diarrhea 3. Other important clinical features were chronic Ear discharge, disseminated TB, Hepatomegaly, recurrent skin infections. 4. There was an increasing trend in rate of sero positivity with single to more number of these clinical features