[HIV infection in children in Poland - clinical advancement at time of diagnosis]

Abstract

At the end of 2006, there were about 130 children with confirmed HIV infection in Poland, 90% of them being infected vertically.

Aim: to present the causes, the diagnostic procedure of HIV infection and the assessment of clinical staging at diagnosis of vertical infection in a child.

Materials and methods: between 1987-2006 there were 86 HIV infected children (45 male, 41 female) treated in our Department. 78 children had been infected vertically, 8 by other route. Reasons for HIV testing in children and clinical staging at diagnosis were analysed in vertically infected children. The patients were divided into two groups: I - diagnosed because of clinical signs and symptoms, II - because of knowledge of HIV positive status in family members.

Results: there were 22/79 children in group I and 56/79 in group II. Vertical HIV infection diagnosis was confirmed at the age from 1 month to 11 years, the mean age was: 26 months - in group I, 25 months - in group II. During the first year of life HIV infection was diagnosed in 36 children (33% of them having AIDS, 36% severe immunodeficiency), at the age of 12-35 months in 22 children (23% of them having AIDS, 32% severe immunodeficiency) and above 35 months in 20 children (15% of them having AIDS, 35% severe immunodeficiency), respectively. Children diagnosed because of clinical manifestations were more likely to have AIDS (p<0.01) and severe immunodeficiency (p<0.07).

Conclusions: early diagnosis in children relies on the knowledge on the mother's HIV infection positive status. In Poland vertical HIV infection diagnosis is established late (mean: above 2 years), often at the advanced stage of the disease.