The changing profile of paediatric HIV infection: An experience from the Middle East

Abstract

Objective: To describe the clinical and epidemiological profiles of HIV-infected Omani children before and after the implementation of the prevention of mother-to-child transmission of HIV (PMTCT) programme. Methods: A retrospective review of HIV-infected children seen at a national paediatric HIV unit between 1992 and 2015 was performed. Results: Ninety-one HIV-infected children were identified; 59 (65%) were ≤5 years of age at diagnosis, with 28 (47.5%) of these being <1 year old. The average annual incidence of infection per million children (≤14 years old) was 5.7, and the highest (11.6) was in 2010. At diagnosis, 48 (60%) patients had a CD4 count of ˂200 cells/mm3. The median HIV viral load was 81 600 copies/ml at diagnosis and 5911 copies/ml at 12 months after HIV treatment (p = 0.015). The median CD4 count was 586 cells/mm3 at diagnosis and 800 cells/mm3 at 12 months after therapy (p = 0.004). Compared to those diagnosed before 2009 (n = 68), HIV-infected children diagnosed after 2009 (n = 22) were more likely to be asymptomatic at the time of HIV diagnosis (23.5% (16/68) vs. 59.1% (13/22); p = 0.002) and to have a favourable clinical outcome (42.6% (29/68) vs. 86.4% (19/22); p < 0001). Conclusions: The number of HIV-infected children in Oman has decreased substantially since the introduction of the PMTCT programme. Furthermore, the HIV-infected children diagnosed after 2009 had higher proportions of asymptomatic HIV infections at diagnosis and favourable clinical outcomes, in comparison to those diagnosed before 2009.

Keywords

• AIDS
• Children
• HIV
• Infection
• Mother-to-child transmission
• Oman