Dramatic decreases in hospitalizations noted among Thai children with HIV

The number of hospitalizations among Thai children with HIV decreased dramatically in the era after antiretroviral therapy was introduced, according to findings presented at the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco.

The findings also indicate that the median age of children who were hospitalized increased in more recent years.

The aim of the study was to determine characteristics and causes of hospitalization of children with HIV who were admitted to Chiang Mai University hospital between 1989 and 2008. The researchers analyzed 1,112 hospitalizations and stratified data into three time periods: the pre-Pneumocystis jirovecii pneumonia prophylaxis era (first case-1995), the pre-ART era (1996-2002) and the ART era (2003-2008).

The mortality rate was 38.1% during the first period, 23.8% in the second and 12.2% in the third.

In the breakdown of hospitalizations, there were 799 AIDS-defining illnesses and 313 non-AIDS-defining illnesses. Of the AIDS-defining illnesses, 653 were opportunistic infections, 131 were non-opportunistic infections and 15 were immune restoration syndromes.

The most commonly reported opportunistic infections were severe bacterial infections and systemic fungal infections.

Chronic lung diseases, including lymphoid interstitial pneumonitis and bronchiectasis, were the leading causes of non-opportunistic infections. Other non-opportunistic infections reported were hematological causes such as thrombocytopenia and anemia, and neurological causes. This pattern of infections was observed across all three periods.

The instances of severe immune restoration syndrome were all reported in the ART era. There were 10 cases of immune restoration syndrome that were linked to Mycobacterium spp. infection. – by Rob Volansky

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