382例艾滋病患儿临床特征分析

Clinical characteristics analysis of 382 children with AIDS

目的分析广西15岁以下艾滋病(AIDS)患儿的临床特征。方法对2004年9月至2012年12月,广西壮族自治区疾病预防控制中心抗病毒治疗门诊收治的15岁以下艾滋病病毒(HIV)感染儿童的资料进行分析。结果共收治382例AIDS患儿,98.69%(377/382)患儿的HIV感染途径为母婴传播。临床症状以发热(24.87%,95/382)、腹泻(16.75%,64/382)多见;体征以中/重度营养不良(49.74%,190/382)、淋巴结肿大(30.10%,115/382)、皮疹(20.42%,78/382)多见;机会性感染以肺炎(24.08%,92/382)、鹅口疮(18.85%,72/382)、上呼吸道感染(15.71%,60/382)多发。以世界卫生组织(WHO)临床分期Ⅲ/Ⅳ期为主,分别为39.79%(152/382)、30.89%(118/382)。免疫状态多受到中/重度抑制,分别为26.70%(102/382)、69.11%(264/382)。5岁以前HIV感染儿童病毒载量较高。受感染儿童身高、体重均明显低于正常同龄儿。结论儿童感染HIV后,发病潜伏期短,免疫系统抑制较快,临床症状多样且复杂,严重影响生长发育,因此早发现、早治疗对于儿童患者尤为重要。

Objective To study the clinical characteristics of children less than 15 years old with acquired immu nodeficiency syndrome （AIDS） in Guangxi. Conclusion The human immunodeficiency virus （HIV） infected chil dren starting treatment from January 2004 to January 2009 in Guangxi CDC were recruited and their clinical syn dromes were analyzed. Results The study recuited 382 children. Among them, 98.69% （377/382） were infected by vertical transmission. The main clinical characteristics were fever [24.87% （95/382）] and diarrhea [16.75% （64/382）]. The major signs were moderate/severe malnutrition [49. 74%（190/382）], lymphadenopathy [30. 10% （115/382）] and rash [20.42% （78/382）]. The main opportunistic infections were pneumonia [24.08% （92/382）], thrush [18. 85 % （72/382）], upper respiratory tract infection [15.71% （60/382）]. According to World Health Or ganization（WHO） definitions, 39.79%（152/382） were classified as stageⅢ , 30.89%（118/382） were classified as stageⅣ The percentage of moderate and severe immunosuppression was 26.70% （102/382） and 69.11% （264/ 382）, respectively. HIV infected children less than 5 years often had higher viral loads. The height and weight of infected children were significantly lower than those of normal children. Conclusions The incubation period of HIV infection in children was short and the immune system were suppressed rapidly. The symptoms and signs were com plex and varied, and the growth and development were affected seriously. So early discovery and early treatment is especially important for these children.