Status gizi dan gambaran klinis penyakit pada pasien HIV anak awal terdiagnosis

https://doi.org/10.22146/ijcn.62154

Ratni Indrawanti(1), Egi Arguni(2), Ida Safitri Laksanawati(3), Dwiyanti Puspitasari(4), Dominicus Husada(5*)

(1) Divisi Infeksi dan Penyakit Tropis, Departemen/SMF Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Airlangga/ Rumah Sakit Umum Daerah Dr. Soetomo, Surabaya
(2) Divisi Infeksi dan Penyakit Tropis, Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada/ KSM Kesehatan Anak, Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta
(3) Divisi Infeksi dan Penyakit Tropis, Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada/ KSM Kesehatan Anak, Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta
(4) Divisi Infeksi dan Penyakit Tropis, Departemen/SMF Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Airlangga/ Rumah Sakit Umum Daerah Dr. Soetomo, Surabaya
(5) Divisi Infeksi dan Penyakit Tropis, Departemen/SMF Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Airlangga/ Rumah Sakit Umum Daerah Dr. Soetomo, Surabaya
(*) Corresponding Author

Abstract


Nutritional status and clinical disease of HIV children patients when diagnosed for the first time

Background: Human immunodeficiency virus (HIV) infection in children can cause nutritional problems. Currently, HIV-infected children are still diagnosed when the disease stage is advanced. Nutritional status is a marker of advanced stage conditions in HIV infection.

Objective: To determine the clinical findings of disease and nutritional status of HIV children patients when diagnosed for the first time.

Methods: We conducted a cross-sectional descriptive study. The data were taken from the medical record documents of child patients aged 0-18 years with the ICD 10 code B20, who was treated at the Dr. Sardjito Yogyakarta Hospital from 1 January 2004-31 December 2019. 

Results: There were 191 children diagnosed with HIV, 56% of them were boys. The median age was 34 months (IQR 25: 13 months, IQR 75: 69 months), and 95.5% among those were infected perinatally. There were 77 (40,3%) children who suffered from severe malnutrition and 55 (28.8%) children were moderate acute malnutrition. At the age of 0-60 months among them, there were 49 children (36.3%) suffered from severely underweight, 35 children (25.9%) underweight, 53 (39.3%) severely stunted, 38 (28.1%) stunted, 28 severely wasted (20.7%), and wasted as many as 24 (17.8%). At the age of 5-18 years old, there were 19 (33.9%) and 5 (8.9%) children who suffered from severely wasted and wasted respectively. World Health Organization (WHO) stages 3 and 4 were experienced by 62 (32.5%) and 68 (35.6%) children. As many as 41.3% of children had enlarged lymph nodes, thrush (40.8%), pneumonia (40.8%), and persistent or chronic diarrhea (21.5%). 

Conclusions: The nutritional status of HIV-infected children at baseline was dominated by underweight and stunted. The most clinical findings of the disease when the child was diagnosed with HIV infection were lymphadenopathy, oral thrush, pneumonia, and persistent or chronic diarrhea.


Keywords


children; clinical disease; HIV; nutritional status

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References

  1. Roser, Ritchie. HIV/AIDS [series online] 2020 [cited 2020 Maret 4]. Available from: URL: https://ourworldindata.org/hiv-aids
  2. Ogunbosi BO, Oladokun RE, Brown BJ, Osinusi KI. Prevalence and clinical pattern of paediatric HIV infection at the University College Hospital, Ibadan, Nigeria: a prospective cross-sectional study. Ital J Pediatr. 2011;37:29. doi: 10.1186/1824-7288-37-29
  3. Adem AK, Alem D, Girmatsion F. Factors affecting survival of HIV positive children taking antiretroviral therapy at Adama Referral Hospital and Medical College, Ethiopia. J AIDS Clin Res. 2014;5(3):289. doi: 10.4172/2155-6113.1000289
  4. Rose AM, Hall CS, Martinez-Alier N. Aetiology and management of malnutrition in HIV-positive children. Arch Dis Child. 2014;99(6):546-51. doi: 10.1136/archdischild-2012-303348
  5. Cotton MF, Violari A, Otwombe K, Panchia R, Dobbels E, van Rensburg AJ, et al. Early limited antiretroviral therapy is superior to deferred therapy in HIV-infected South African infants: results from the children with HIV early antiretroviral (CHER) randomized trial. Lancet. 2013;382(9904):1555-63. doi: 10.1016/S0140-6736(13)61409-9
  6. World Health Organization (WHO). Child growth standards WHO. [series online] 2006 [cited 2020 Desember 11]. Available from: URL: https://www.who.int/toolkits/child-growth-standards
  7. World Health Organization (WHO). Growth reference data for 5-19 years. [series online] 2007 [cited 2020 Desember 11]. Available from: URL: https://www.who.int/toolkits/growth-reference-data-for-5to19-years
  8. Pillay K. Lymph node pathology in the HIV-positive child. Diagnostic Histopathology. 2009;15(5):241-50. doi: 10.1016/j.mpdhp.2009.02.008
  9. Mayoclinic. Oral thrush. [series online] 2018 [cited 2020 Desember 10]. Available from: URL: https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533
  10. Centers for Disease Control and Prevention (CDC). Chronic diarrhea. [series online] 2016 [cited 2020 Desember 10]. Available from: URL: https://www.cdc.gov/healthywater/hygiene/disease/chronic_diarrhea.html
  11. World Health Organization (WHO). Pneumonia. [series online] 2019 [cited 2020 Desember 10]. Available from: URL: https://www.who.int/news-room/fact-sheets/detail/pneumonia
  12. World Health Organization (WHO). HIV. [series online] 2019 [cited 2020 Desember 10]. Available from: URL: https://www.who.int/teams/global-hiv-programme/hiv-prevention/mother-to-child-transmission-of-hiv
  13. Adedemy JD, Agbeille MF, Agossou J, Noudamadjo A, Kpanidja G, et al. Five years sur-vival trend and outcome among HIV infected children followed up in the pediatric department in a tertiary hospital. Int J Pediatr Res. 2019;5:052. doi: 10.23937/2469-5769/1510052
  14. Thorne C, Newell ML. Prevention of mother-to-child transmission of HIV infection. Curr Opin Infect Dis. 2004;17(3):247-52. doi: 10.1097/00001432-200406000-00013
  15. Mutanga JN, Mutembo S, Ezeamama AE, Song X, Fubisha RC, Whalen CC, et al. Long-term survival outcomes of HIV infected children receiving antiretroviral therapy: an observational study from Zambia (2003–2015). BMC Public health. 2019;19:115. doi: 10.1186/s12889-019-6444-7
  16. Zanoni BC, Phungula T, Zanoni HM, France H, Feeney ME. Risk factors associated with increased mortality among HIV infected children initiating antiretroviral therapy (ART) in South Africa. PloS one. 2011;6(7):e22706. doi: 10.1371/journal.pone.0022706
  17. Collins IJ, Jourdain G, Hansudewechakul R, Kanjanavanit S, Hongsiriwon S, Le Coeur S, et al. Long-term survival of HIV-infected children receiving antiretroviral therapy in Thailand: a 5-year observational cohort study. Clin Infect Dis. 2010;51(12):1449-57. doi: 10.1086/657401
  18. Zar HJ, Hanslo D, Tannenbaum E, Klein M, Argent A, Bateman ED, et al. Aetiology and outcome of pneumonia in human immunodeficiency virus‐infected children hospitalized in South Africa. Acta Paediatr. 2001;90(2):119-25.
  19. Akintan PE, Adebola A, Edamisan T, Esezobor C. Prevalence of wasting, stunting, and underweight among HIV infected underfives', in Lagos using WHO z score. Nigerian Quarterly Journal of Hospital Medicine. 2015;25(2):124-8.
  20. World Health Organization (WHO). Malnutrition. [series online] 2020 [cited 2020 Desember 14]. Available from: URL: https://www.who.int/health-topics/malnutrition#tab=tab_1
  21. Sashindran VK, Thakur R. Malnutrition in HIV/AIDS: aetiopathogenesis. In: Nutrition and HIV/AIDS-Implication for Treatment, Prevention and Cure. [series online] 2020 [cited 2020 Desember 14]. Available from: URL: https://ideas.repec.org/h/ito/pchaps/178250.html
  22. Dikman AE, Schonfeld E, Srisarajivakul NC, Poles MA. Human immunodeficiency virus-associated diarrhea: still an issue in the era of antiretroviral therapy. Dig Dis Sci. 2015;60(8):2236-45. doi: 10.1007/s10620-015-3615-y
  23. Duggal S, Chugh TD, Duggal AK. HIV and malnutrition: effects on immune system. Clin Dev Immunol. 2012;2012:784740. doi: 10.1155/2012/784740
  24. Huang Z, Liu Y, Qi G, Brand D, Zheng SG. Role of vitamin A in the immune system. J Clin Med. 2018;7(9):258. doi: 10.3390/jcm7090258
  25. Lewis ED, Meydani SN, Wu D. Regulatory role of vitamin E in the immune system and inflammation. IUBMB life. 2019;71(4):487-94. doi: 10.1002/iub.1976
  26. Evalina R. Studi deskriptif infeksi HIV pada anak di Rumah Sakit Umum Pusat Adam Malik Medan. Sari Pediatri. 2012;14(2):73-8. doi: 10.14238/sp14.2.2012.73-8
  27. Head BM, Mao R, Keynan Y, Rueda ZV. Inflammatory mediators and lung abnormalities in HIV: a systematic review. PloS one. 2019;14(12):e0226347. doi: 10.1371/journal.pone.0226347
  28. Iriart X, Witkowski B, Cassaing S, Abbes S, Menard S, Huynh A, et al. Alveolar and blood T lymphocyte profiles in Pneumocystis jirovecii–positive patients: effects of HIV status. J Infect Dis. 2011;204(4):544-53. doi: 10.1093/infdis/jir302
  29. Jambo KC, Sepako E, Fullerton DG, Mzinza D, Glennie S, Gordon SB, et al. Bronchoalveolar CD4+ T cell responses to respiratory antigens are impaired in HIV-infected adults. Thorax. 2011;66(5):375-82. doi: 10.1136/thx.2010.153825
  30. Bachou H, Tylleskär T, Downing R, Tumwine JK. Severe malnutrition with and without HIV-1 infection in hospitalised children in Kampala, Uganda: differences in clinical features, haematological findings and CD4+ cell counts. Nutr J. 2006;5:27. doi: 10.1186/1475-2891-5-27



DOI: https://doi.org/10.22146/ijcn.62154

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