ABSTRACT
Excessive weight loss due to protein calorie malnutrition (PCM) is a significant problem in Nigerian children. This syndrome may be difficult to differentiate from the wasting disease caused by human immunodeficiency virus type 1 (HIV-1) infection. We studied 70 children admitted to the Baptist Medical Center in Ogbomosho, Nigeria in 1990 with PCM for prevalence of antibodies to HIV-1 and HIV-2. The cohort was from low-risk mothers and had a median age of 25 months (range, 4 months-9 years) with a weight deficit of at least 20% of the theoretical weight for age. Two sera were positive for anti-HIV-1 by both ELISA and Western blot (WB). A high prevalence of samples negative for HIV-1 antibody by ELISA were repeatedly reactive (11%, 8/70) or indeterminate (46%, 32/70) by WB. None of the sera was positive for antibody to HIV-2. There was no correlation of ELISA positivity or extent of WB banding with successful recovery from malnutrition. These results indicate a relatively low but significant prevalence of HIV-1 infection in Nigerian children with PCM. The high prevalence of indeterminate reactions in WB assays for HIV-1 suggests that other procedures may be necessary for confirmatory diagnosis of HIV-1 infection in this African population.
Subject(s)
HIV Infections/epidemiology , HIV Seroprevalence , HIV-1 , HIV-2 , Protein-Energy Malnutrition/epidemiology , Blotting, Western , Child , Child, Preschool , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Female , HIV Antibodies/analysis , HIV Infections/immunology , HIV Seropositivity/epidemiology , HIV-1/immunology , HIV-2/immunology , Humans , Infant , Male , Nigeria/epidemiologyABSTRACT
A 60-year-old Filipino man, who presented with left sided abdominal pain and weight loss, was found to have splenomegaly, an abnormal spleen scan and a leukemoid reaction. Primary splenic hemangiosarcoma was found at splenectomy. Metastases first occurred in the cervical lymph nodes two years after diagnosis. Despite treatment with doxorubicin and radiation therapy there was recurrence in lymph nodes and scan evidence of liver and bone metastases. The patient died 38 months after diagnosis. A liver-spleen scan is helpful in establishing an early diagnosis, and splenectomy before rupture occurs is advisable. The role of chemotherapy needs to be defined.
