HIV Encephalopathy (HIVE) in Children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria

Abstract

Background: HIV encephalopathy (HIVE) is associated with cognitive impairment in children with HIV infection, early diagnosis and initiation of HAART may reduce the morbidity associated with HIVE. Objective: To determine the prevalence of HIVE and associated comorbiditiesin children at the UPTH. Methodology: This was a retrospective study carried out from January to June 2017. The case notes of all HIV positive children presenting to the Paediatric Department of the University of Port Harcourt Teaching Hospital (UPTH) were studied. Children who met the diagnostic criteria for HIVE according to the Centre for Disease Control (CDC) definition were selected. The socio-demographic characteristics of the patients, mode of HIV transmission, CD4 count and associated comorbidities in these children were retrieved from the case notes. Obtained data was analyzed using Epi Info version 7.2. Comparisms of subgroups was carried out using the chi square test while statistical significance at 95% confidence interval was p value < 0.05. Results: A total of thirty five out of the 196 HIV positive children presenting to the hospital had HIV encephalopathy (HIVE) giving a prevalence rate of 17.9%. Of these 35 children, 18 were males and 17 females, giving a male to female ratio of 1:1. The mean age of the children was 5.7 ± 3.1 years. The mean age for the males was 6.4 ± 3.2 years and 5.0 ± 2.8 years for the females. There was no statistically significant difference observed between the sexes (t = 1.35, p = 0.187). Thirty (85.7%) of the patients with HIVE were on HAART at diagnosis. The mean age at diagnosis of HIV was 3.2 ± 3.1 years and the mean age at diagnosis of HIV encephalopathy was 3.4 ± 3.2 years. The documented route of transmission for all the subjects was mother-to-child-transmission (MTCT). Seventy five percent of the children were breastfed from birth and at 6 months all the mothers had discontinued breastfeeding. The mean CD4 count was 1053 ± 630 cells/ml. Tuberculosis was the most prevalent co-morbidity occurring among the patients. Conclusion: The prevalence of HIVE in children at the UPTH is high and Tuberculosis is the commonest comorbidity. Early infant diagnosis, use of modern diagnostic tool and early initiation of HAART are advocated to reduce its associated morbidity.