ISSN 0973 - 9289

August 2015 NEWSLETTER

HIV IN CHILDREN
August 2015 Newsletter
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GRAND ROUNDS
A 3 years old HIV infected girl presented with cough for 10 days, fever for 5 days and breathlessness for 5 days. Presently the child was severely malnourished, had clubbing, pallor, generalized lymphadenopathy, pneumonia, cardiomegaly and hepatosplenomegaly. Echocardiography showed moderate pulmonary hypertension. She received antituberculous therapy (ATT) for the same and antiretroviral therapy (ART) in form of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP) was started. However, the bilateral crepitations and Chest X-Ray continued to be the same. Her ATT was stopped after 1 year of therapy. She continued to have recurrent respiratory infections for which she required multiple courses of antibiotics. Two years later she presented with cough with expectoration and Chest X-Ray showed cavity in right midzone. Sputum smear for AFB was positive and she was started on category 2 of ATT. Culture for TB was negative. She was advised change of ART regimen in view of recurrent chest infections but has been unable to do the same in view of non-affordability and is on regular follow-up.

What is the cause of her recurrent chest infections?

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Question Of the Day
Q. A 10 years old female child is newly diagnosed as hiv positive. She has completed ATT 5 yrs back. Her cd4 count is 426. She is asymptomatic for tuberculosis. Should we start art in this child?
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