Peer-reviewed article
A multicenter study on the profile of fungal infections in children infected with HIV in tertiary hospitals in South Western Nigeria
Olusola Adetunji Oyedeji, Joseph Babafunso Ayinde, Odunayo Afolayan, Funso Abidemi Olagunju, Temitope Oyelami et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study reviewed the case records of 175 children living with HIV in three tertiary hospitals in South West Nigeria to describe which fungal infections they had and how they fared. Almost half (47.4%) had skin and related fungal infections (dermatophytosis) and 13.7% had invasive fungal infections. Invasive infections were linked to more hospital admissions and deaths, and were more common in infants, in children not on antiretroviral therapy, and in children of low socioeconomic status. The authors report that diagnostic tests for Pneumocystis pneumonia and cryptococcal disease were lacking, and that fluconazole was the only antifungal available for cryptococcal meningitis.
Key points
- Of 175 children with HIV, 83 (47.4%) had dermatophytosis and 24 (13.7%) had invasive fungal infections.
- 61 children (34.9%) were admitted and 12 (6.9%) died; nine of the 12 deaths were due to invasive fungal infections.
- Infants and children not on HAART had higher rates of invasive fungal infections (p < 0.01).
- Admission and death rates were higher among children with invasive fungal infections (p < 0.01).
- Higher rates of fungal infections were found among children of low socioeconomic status (p < 0.05); diagnostics were lacking and fluconazole was the only antifungal available for cryptococcal meningitis.
Limitations
This is a retrospective review of case records from three tertiary hospitals, so it cannot show how common these infections are in children outside hospital care or establish cause and effect. The abstract does not describe how infections were confirmed, which is a concern given the reported lack of diagnostics.
Abstract
Background Fungal infections in children infected with human immunodeficiency virus (HIV) are a significant cause of morbidity and mortality. However, there are no reports on this subject in Nigerian children. Objective This study aimed to document the spectrum of fungal infections and their outcomes in Nigerian children infected with HIV. Methodology The case records of all children infected with HIV in three South West Nigerian tertiary hospitals were studied. Data on the identified fungal infection, clinical presentation, and outcomes were obtained and analyzed. Results A total of 175 children infected with HIV, comprising 89 (50.9%) boys and 86 (49.1%) girls, with ages ranging from 2 months to 16 years, were studied. Of the population studied, 83 (47.4%) had dermatophytosis and 24 (13.7%) had invasive fungal infections (IFIs). Tinea capitis, thrush (pityriasis versicolor), and tinea corporis constituted more than 75% of the dermatophytosis. Invasive candidiasis, Pneumocystis pneumonia, cryptococcal disease, and aspergillosis accounted for more than 95% of the IFIs. Among the 175 children, 61 (34.9%) admissions and 12 (6.9%) deaths were recorded. Nine of the 12 deaths were due to IFIs. Infants and children not on Highly Active Anti-Retroviral Therapy had higher rates of IFIs ( p < 0.01). Admission and death rates were higher among those with IFIs ( p < 0.01). Higher rates of IFIs and dermatophytosis were found among those with a low socioeconomic status ( p < 0.05). Appropriate diagnostics were lacking for Pneumocystis pneumonia and cryptococcal disease diagnosis. Fluconazole was the only antifungal available and accessible for cryptococcal meningitis management. Conclusion Fungal infections cause significant morbidity and mortality in children infected with HIV. Appropriate diagnostics and medications must be made accessible to reverse IFI treatment outcomes.