Severe HIV disease in neonates- report of six cases

Abstract

Summary Among infants with maternally transmitted human immunodeficiency virus (HIV) infection there may be rapid progression of disease especially when infected at an early stage of development, resulting in the onset of severe immunodeficiency and clinical disease soon after birth. This is a case report of six neonates who fulfilled the WHO criteria for presumptive diagnosis of severe HIV disease based on the presence of some clinical signs and symptoms. Cases 1 and 6 had severe wasting and severe sepsis, case 2 had severe wasting, oral thrush and severe sepsis, case 3 had severe pneumonia, oral thrush and severe sepsis, case 4 had severe pneumonia and severe sepsis, while case 5 had severe wasting and oropharyngeal thrush. DNA polymerase chain reaction (PCR) was positive in cases 5 and 6. Where HIV virologic studies are largely unavailable, clinical and immunologic criteria can be used for a presumptive diagnosis of severe HIV infection in children younger than 18 months.