HIV-Associated Morbidity In Adolescents

Main Category: HIV / AIDS
Article Date: 16 Feb 2010 - 0:00 PDT


Nearly half of adolescents admitted to two public hospitals in Zimbabwe were HIV positive according to a new paper by Rashida Ferrand and colleagues which is published in this weeks PLoS Medicine. This study, which examines the causes of otherwise unselected acute hospitalization in adolescents, serves to highlight the growing crisis of HIV acquired at birth in teenagers and young adults in the developing world.

Each 10-18 year old participant completed a questionnaire about themselves and their health and underwent standard investigations, including HIV testing. Nearly half of participants were HIV positive; they were more likely to be stunted, to have pubertal delay, and to be maternal orphans or have an HIV-infected mother than HIV-negative adolescents. 69% of HIV-positive participants were admitted to hospital because of infections such as tuberculosis or pneumonia whereas only 19% of the HIV-negative participants were admitted for infections. Finally, 22% of the HIV-positive participants died while in hospital compared to only 7% of the HIV-negative participants.

In an accompanying commentary, Glenda Gray (uninvolved in the research) from the Perinatal HIV research Unit at the University of Witwatersrand in South Africa points out that few studies have addressed the prevalence of perinatally acquired HIV in older children and adolescence, perhaps because it was thought that children infected at birth were unlikely to survive beyond 5 years of age. Additionally, whilst Ferrand and colleagues assessed causes of hospitalization such as infectious disease or chronic underlying disease, they did not assess underlying mental health conditions. In the developed world, Gray points out that the most common reasons for psychiatric hospitalization for HIV infected children were for depression or behavioral disorders and calls for the impact of death and chronic ill health of caregivers or siblings on HIV-infected adolescents in the developing world required investigation.

Funding: RAF and ELC are funded by the Wellcome Trust. The Wellcome Trust had no role in collection, analysis or interpretation of data or in the decision to submit the paper for publication. RAF had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Competing Interests: The authors have declared that no competing interests exist.

Citation: "Causes of Acute Hospitalization in Adolescence: Burden and Spectrum of HIV Related Morbidity in a Country with an Early-Onset and Severe HIV Epidemic: A Prospective Survey"
Ferrand RA, Bandason T, Musvaire P, Larke N, Nathoo K, et al. (2010)
PLoS Med 7(2): e1000178.

Source
PLoS Medicine

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