PRESENTATION AND OUTCOME OF HIV-1 INFECTION IN HOSPITALIZED INFANTS AND OTHER CHILDREN IN NORTH-EASTERN NIGERIA

There is limited information on HIV infection in children in West Afri ca, This prospective case series study was done to determine the size of the problem and the feasibility of selective screening for infectio n based on clinical presentation, It involved infants and other childr en admitted to the Children's Emergency Ward and Paediatric Medical Wa rd of the University of Maiduguri Teaching Hospital, Nigeria, from the beginning of September 1992 to the end of September 1994, Clinical ev aluation followed by serologic tests (ELISA and Western blot technique s) was undertaken, Descriptive study; frequencies were compared using chi 2 test for Fisher's exact test as appropriate, One hundred and nin ety nine (10.9%) of 1,822 admissions were screened, One hundred and fi fty eight (79.4%) were ELISA negative and 17 (8.6%) ELISA and WB posit ive; a further 10 (5%) were ELISA positive but WB indeterminate and 14 (7%) were ELISA positive but WB negative in 12 or untested in two. Al l the infections were HIV-l. Sixteen (39%) patients (nine WB positive, three WB indeterminated and four ELISA positive only) are dead, 14 fr om HIV-related illnesses, two (4.9%) are alive and 23 (56.1%) lost to follow up; 11 of the HIV-related deaths involved infants, Presence of persistent diarrhoea, prolonged fever, oral thrush, hepatosplenomegaly , diagnosis of tuberculosis and severe malnutrition with gastroenterit is, and multiple (>3) diagnosis on admission were significantly (p<0.0 5) associated with WB confirmed HIV-1 seropositivity and could serve a s indicators for selective screening, HIV-1 infection in hospitalised infants and children has become an important problem in Nigeria, prese ntation in infancy is associated with a high case fatality rate, and t he practice of selective screening based on clinical presentation woul d appear to be feasible.