CLINICAL MANIFESTATIONS OF INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS AMONG ADOLESCENTS IN LOUISIANA

Purpose: There is limited information regarding the clinical manifesta tions of human immunodeficiency virus (HIV) infection among adolescent s. To better define the clinical presentation and course of HIV diseas e in this population, a retrospective review of all HIV-infected perso ns age 13-21 years at entry into a public, inner-city HIV outpatient c linic in New Orleans, Louisiana, was undertaken. Results: A total of 1 41 adolescents were included in this study. The cohort was predominant ly female (65%) and African-American (83%), and acquired HIV infection through sexual contact (89%). As many as 75% of the females and 48% o f the males were diagnosed with at least one sexually transmitted dise ase (STD), respectively, and young African-American females with a CD4 cell count > 500/mm(3) were at highest risk. The proportions of femal e adolescents having a gravida greater than or equal to 1 and 2 were 8 2% and 20%, respectively. A. total of 55% of females were diagnosed wi th squamous intraepithelial lesions (SIL) at least once. Similar to ad ults, the majority of opportunistic processes occurred in adolescents with a CD4 cell count < 200/mm(3). Known HIV-related symptoms (oral ha iry leukoplakia, thrush, and tester) were significantly predictive (p < .0001) for HIV disease progression. Conclusions: Although HIV-relate d symptoms and infections do not arrear to be unique in the adolescent population, it is clear that STDs and pregnancies are common among fe male adolescents. Our results emphasize the need for aggressive STD an d contraceptive protection counseling, and surveillance screening for STDs and cervical dysplasia.