The changing profile of paediatric HIV infection: An experience from the Middle East

Int J Infect Dis. 2020 Aug:97:347-351. doi: 10.1016/j.ijid.2020.06.013. Epub 2020 Jun 9.

Abstract

Objective: To describe the clinical and epidemiological profiles of HIV-infected Omani children before and after the implementation of the prevention of mother-to-child transmission of HIV (PMTCT) programme.

Methods: A retrospective review of HIV-infected children seen at a national paediatric HIV unit between 1992 and 2015 was performed.

Results: Ninety-one HIV-infected children were identified; 59 (65%) were ≤5 years of age at diagnosis, with 28 (47.5%) of these being <1 year old. The average annual incidence of infection per million children (≤14 years old) was 5.7, and the highest (11.6) was in 2010. At diagnosis, 48 (60%) patients had a CD4 count of ˂200cells/mm3. The median HIV viral load was 81600copies/ml at diagnosis and 5911copies/ml at 12 months after HIV treatment (p=0.015). The median CD4 count was 586cells/mm3 at diagnosis and 800cells/mm3 at 12 months after therapy (p=0.004). Compared to those diagnosed before 2009 (n=68), HIV-infected children diagnosed after 2009 (n=22) were more likely to be asymptomatic at the time of HIV diagnosis (23.5% (16/68) vs. 59.1% (13/22); p=0.002) and to have a favourable clinical outcome (42.6% (29/68) vs. 86.4% (19/22); p<0001).

Conclusions: The number of HIV-infected children in Oman has decreased substantially since the introduction of the PMTCT programme. Furthermore, the HIV-infected children diagnosed after 2009 had higher proportions of asymptomatic HIV infections at diagnosis and favourable clinical outcomes, in comparison to those diagnosed before 2009.

Keywords: AIDS; Children; HIV; Infection; Mother-to-child transmission; Oman.

MeSH terms

  • Adolescent
  • Adult
  • CD4 Lymphocyte Count
  • Child
  • Child, Preschool
  • Female
  • HIV Infections / blood
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • Humans
  • Infant
  • Infectious Disease Transmission, Vertical / statistics & numerical data
  • Male
  • Oman / epidemiology
  • Retrospective Studies
  • Young Adult