Opportunistic infections and complications in human immunodeficiency virus-1-infected children correlation with immune status

ABSTRACT

The aim of this study was to ascertain the correlation between various opportunistic infections and complications in human immunodeficiency virus [HIV]-l -infected children and the immune status of these patients, evaluated by absolute cluster of differentiation 4 [CD4] count and CD4 percentage. This study was conducted from January 2009 to June 2010 at the Antiretroviral Treatment Centre of the Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, a tertiary care hospital in Rohtak, Haryana, in northern India. A total of 20 HIV-l-infected children aged 4-57 months were studied. Demographic and baseline investigations were performed prior to the start of highly active antiretroviral therapy [HAART]. A fixed-dose combination of HAART was given based on the patient's weight. Baseline investigations were repeated after six months of HAART. Results: There was a significant increase in the patients' haemoglobin, weight, height and CD4 count after six months of HAART. Significant improvements [P <0.05] were also noted in the patients' immune status, graded according to the World Health Organization, Conclusion: This study observed that the severity and frequency of opportunistic complications in paediatric patients with HIV-1 increased with a fall in the CD4 count. The treatment of opportunistic infections, along with antiretroviral therapy, may lead to both clinical and immunological recovery as well as a decreased incidence of future opportunistic infections. The CD4 count may give treating physicians an initial idea about the immune status of each child and could also be used as a biological marker of HAART efficacy. Patient compliance must be ensured during HAART as this is a key factor in improving outcomes: