MANIFESTACIONES INICIALES DE LA INFECCIÓN POR EL VIRUS DE INMUNODEFICIENCIA HUMANA EN PEDIATRÍA

SUMMARY: Pediatric HIV infection shows different manifestations whose recognition allows an early diagnostic approach. Objective: To determine the initial manifestations in HIV pediatric patients. Method: It was a comparative and retrospective study that included HIV patients who attended to Hospital de Ninos “J.M. de los Rios”(Caracas, Venezuela), between 1987-2006. Data were obtained from HIV consultation Data Base. According to HIV transmission, we established two groups: vertical and horizontal. The initial manifestation and the patient age at that moment were recorded, so was the HIV diagnosis age. The frequencies were compared by square chi method. Results: There were 191 patients: 80,1% in the vertical group and 19,9% in the horizontal one. There were 5,2% of asymptomatic patients, 33,5% had inespecific manifestations, 41,9% had HIV/no AIDS symptoms and 19,4% had HIV/AIDS symptoms. The most frequently seen manifestations were: generalized lymphadenopathy (25%), hepatomegaly (16%), recurrent and persistent upper respiratory tract infection (15,1%) , severe bacterial infection (18,2%), chronic diarrhea (11,4%) and splenomegaly (10,9%). The age at the first manifestation was 0,9±0,7 years in the vertical group and 5,5±3,9 years in the horizontal one. The HIV diagnosis age was 2,8±2,7 years in the vertical group and 7,6 ± 4,9 years in the horizontal one. Conclusions: The most frequent manifestations were inespecific: generalized lymphadenopathy, hepatomegaly and upper respiratory tract infection. However, severe bacterial infections and chronic diarrhea are relevant manifestations to suspect HIV infection. HIV diagnosis was done at least two years after the first manifestation in both groups. Arch Venez Pueric Pediatr 70 (4): 113 - 118