... 10. Winter H. Gastrointestinal tract function and malnutrition in HIV-infected children. J Nutr 1996; 126: 2620s. 11. ... 36. Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M. Micronutrient supplementation in the AIDS... more
... 10. Winter H. Gastrointestinal tract function and malnutrition in HIV-infected children. J Nutr 1996; 126: 2620s. 11. ... 36. Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M. Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia. ...
Research Interests:
bstract Objective: To describe the short-term outcome of critically ill HIV-infected children with access to highly active antiretroviral therapy (HAART) in a developing region. Methods: Prospective observational study conducted in a... more
bstract
Objective: To describe the short-term outcome of critically ill HIV-infected children with access to highly active antiretroviral therapy (HAART)
in a developing region.
Methods: Prospective observational study conducted in a paediatric teaching hospital in Cape Town, South Africa. All children admitted to the
paediatric intensive care unit (PICU) with suspected HIV infection were screened. Data are n (%) with 95% confidence intervals (CI).
Results: Sixty-eight of 96 HIV antibody positive children, median age 3 months, were confirmed HIV-infected. Predicted PICU mortality was
0.42. Fifty-one children (75%; CI 65 – 85%) survived to PICU discharge, but hospital survival was only 51% (CI 40 – 63%). Limitation of
intervention (LOI) decisions were a factor in the majority of PICU and ward deaths. Twenty-one PICU survivors (31%; CI 20 - 42%) commenced
HAART, and 2 children were already on treatment. Nineteen children (28%) were considered to be established on HAART after 1 month. Thirteen
HIV-infected children (19%; CI 10 – 28%), representing 25% (CI 14 – 37%) of all PICU survivors, and 68% (CI 48 – 89%) of those PICU
survivors who were established on HAART, remain well on treatment after median 350 days.
Conclusion: The majority of HIV-infected children survived to discharge from PICU, but only half survived to hospital discharge. LOI decisions,
usually made in PICU, directly influenced short-term survival and the opportunity to commence HAART. Although few critically ill HIV-infected
children survived to become established on HAART, the long-term outcome of children on HAART is encouraging and warrants further
investigation.
Objective: To describe the short-term outcome of critically ill HIV-infected children with access to highly active antiretroviral therapy (HAART)
in a developing region.
Methods: Prospective observational study conducted in a paediatric teaching hospital in Cape Town, South Africa. All children admitted to the
paediatric intensive care unit (PICU) with suspected HIV infection were screened. Data are n (%) with 95% confidence intervals (CI).
Results: Sixty-eight of 96 HIV antibody positive children, median age 3 months, were confirmed HIV-infected. Predicted PICU mortality was
0.42. Fifty-one children (75%; CI 65 – 85%) survived to PICU discharge, but hospital survival was only 51% (CI 40 – 63%). Limitation of
intervention (LOI) decisions were a factor in the majority of PICU and ward deaths. Twenty-one PICU survivors (31%; CI 20 - 42%) commenced
HAART, and 2 children were already on treatment. Nineteen children (28%) were considered to be established on HAART after 1 month. Thirteen
HIV-infected children (19%; CI 10 – 28%), representing 25% (CI 14 – 37%) of all PICU survivors, and 68% (CI 48 – 89%) of those PICU
survivors who were established on HAART, remain well on treatment after median 350 days.
Conclusion: The majority of HIV-infected children survived to discharge from PICU, but only half survived to hospital discharge. LOI decisions,
usually made in PICU, directly influenced short-term survival and the opportunity to commence HAART. Although few critically ill HIV-infected
children survived to become established on HAART, the long-term outcome of children on HAART is encouraging and warrants further
investigation.
