Journal Article

Endoscopy Findings in HIV-Infected Children from Sub-Saharan Africa

M. L. Cooke, E. A. Goddard and R. A. Brown

in Journal of Tropical Pediatrics

Volume 55, issue 4, pages 238-243
Published in print August 2009 | ISSN: 0142-6338
Published online January 2009 | e-ISSN: 1465-3664 | DOI: https://dx.doi.org/10.1093/tropej/fmn114
Endoscopy Findings in HIV-Infected Children from Sub-Saharan Africa

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Background: The causes of persistent gastro-intestinal symptoms in HIV-infected children from sub-Saharan Africa remain poorly documented.

Methods: The clinical, radiological and endoscopic findings of all HIV-infected children who underwent upper GI endoscopy at Red Cross Children's Hospital, Cape Town, South Africa, from February 2003 to October 2005 were documented.

Results: Twenty-six HIV-infected children underwent endoscopy; median age 1 year (range: 0.17–10.9 years). The majority had advanced HIV disease; 18 (69%) were WHO Stage 4; median CD4 10.7% (range: 1–39.8%). Presenting symptoms included persistent vomiting (18), dysphagia (4) and GIT bleed (6). Observational and histological findings showed poor correlation. Pathogens were identified in 10 children: cytomegalovirus infection in seven (two with cryptosporidium co-infection), Candida in two, Helicobacter pylori in one. Age and CD4 count were not associated with the pathogens. Endoscopy findings influenced clinical management in 21 (81%) cases.

Conclusion: Upper-GI endoscopy identified a diverse spectrum of disease and provided information that would be clinically relevant to most HIV-infected children with upper gastro-intestinal symptoms.

Journal Article.  2738 words. 

Subjects: Paediatrics

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