Clinical features of respiratory diseases in children with HIV

Background: Respiratory diseases are the most common opportunistic infection in HIV positive children. Diagnosis of certain disease such as tuberculosis is difficult in HIV-positive children dueto the less specific symptoms and less sensitive tuberculin skintest. Objective: To define the prevalence of respiratory diseases and to know the clinical feature of respiratory diseases in children with HIV. Methods: Cross-sectional study carried out in Cipto mangunkusumo Hospital Jakarta. The subjects were all patients with HIV diagnosed January 2005-July 2009. Result: We investigated 186 HIV-infected children with the aged 31.5±2.64 months. Tuberculosis was the most frequent respiratorydiseases (39.2%), followed by upper ARI (25.3%), pneumonia (17.2%) and otitis media (14.5%). Fifty-nine (31.7%) subjects has a good nutritional status, while 88 (47.3%) were moderate malnourished and 39 (21%) subjects were severe malnourished. Subjects weremostly (56%) in severe immunosupression status. Contacts withadult TB were found in 54 (29%) subjects. Most children (53.2% ) complained of chronic recurrent cough. Chronic fever, difficulty in weight gain and anorexia were occurred in 37.8%, 41.2%, and 31.4% subjects respectively. Sixty-five children (34.9%) had lymph node enlargement. We identified 86 subjects performed TST and 13 of them (15%) showed indurations 5 mm and more. Chest radiograph found infiltrates in most subject (37.2%), followed by combination of hillar lymph node enlargement and infiltrates (36%). Atelectasis and consolidation were found in 3 patients. Conclusion: The prevalence of TB in children with HIV was 39.2%. The most common symptoms were chronic recurrent cough, feverand difficulty in weight gain. Tuberculin skin test was positive insome children with HIV.