Ann Trop Paediatr
-
Clinical Trial Controlled Clinical Trial
Pneumocystis carinii and cytomegalovirus infections in severely ill, HIV-infected African infants.
Unlike in the industrialized world, in which Pneumocystis carinii and cytomegalovirus (CMV) are major respiratory opportunistic organisms, the causes of severe pneumonia, which accounts for much of the mortality in HIV-infected infants in developing countries, are not known, although tuberculosis has been associated with HIV in adults. We report on post-mortem lung and liver biopsies obtained soon after death from 36 HIV-infected infants and 36 HIV-uninfected matched controls who had been admitted with severe pneumonia to an ICU. Nineteen of the HIV-infected infants were classified by WHO criteria as having AIDS and 17 'symptomatic HIV'. ⋯ Ante-mortem investigations revealed more CMV infections in AIDS patients (four of 19) than in matched controls (0 of 36; p < 0.01). Tuberculosis was detected in post-mortem lung tissue from only one patient with symptomatic HIV infection. The finding that pathogens (P. carinii, CMV) most frequently detected in seriously ill African infants with HIV/AIDS are similar to those in their counterparts from industrialized countries has implications for improved management in the former.