Abstract

HIV children and adolescents in Cali, Colombia, 1991-2008

L.C. Rubiano Perea

Secretaria de Salud de Santiago de Cali, Vigilancia Epidemiologica, Cali, Colombia

Background: This is a study retrospective descriptive of the clinical manifestations and incidence of opportunistic infections in HIV/AIDS positive in children.
Methods: HIV positive children aged between 18 months to 18 years, registered between January 1991 to December 2008 (18 years)in Health Service of Cali, were reported. Socio-demographic characteristics and clinical manifestations were recorded in the epidemiology office. Children were categorized as per 1994 revised CDC classification of pediatric HIV infection.
Results: Number of HIV positive children registered during study period was 296. Vertical transmission was noted in 84%, which is the major route of transmission, la transmission sexual (14 %) corresponding to pregnant adolescents diagnosed in the prenatal. The ethnic group is mixed with 75% of cases and the Afro-Colombians with 6% and a worrying increase in the indigenous population. The common opportunistic infections observed were tuberculosis (17%), recurrent bacterial pneumonia (12.5%) oral candidiasis (8,4%). The mortality was (21%) 63 children died during the study period, which included 10 (5.63%) cases of co- infection HIV/TB. A total of 20% of children are resistant to antiretroviral treatment and therapy are currently in rescue many of them under 10 years with adequate response. The proportion of orphans of both parents reached (33%) and at least one of the parents (51%)
Vertical transmission was the major route of HIV infection. Persistent fever, cough, loss of appetite and loss of weight were common presenting clinical features. Tuberculosis remains the leading opportunistic infection in this population, with serious difficulties for diagnosis and treatment, increasing the risk for the general population and especially for carers who are usually grandmothers. There is need for establishment of comprehensive HIV control programmers in developing countries which are amenable to prevention. It is necessary to strengthen education programs for grandparents and caregivers who bear the attention of these children and teenagers today.
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