HTLV-III/LAV seroprevalence in pediatric in-patients 2-14 years old in Kinshasa Zaire.

Seroprevalence to human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) was determined among 368 children 2-14 years old admitted to the pediatric service at Mama Yemo Hospital in Kinshasa Zaire. 40 (11%) of these patients and only 1 (1%) of 92 healthy siblings of these patients were seropositive (X2 = 8.68 p 0.01). Seropositivity was associated with previous hospitalization receipt of blood transfusion prior to the current hospitalization (odds ratio 3.1; 95% confidence interval 1.5-6.4) receipt of medical injections during the past year and smaller household size. Clinically HTLV-III/LAV seropositivity was associated with the diagnoses of malnutrition and pneumonia. A higher proportion of seropositive children died during the current hospitalization (4/40 vs. 10/328); when malaria patients were excluded the in-hospital mortality of seropositive children with 8 times higher than that of seronegative children (Fishers exact test p=0.006). Though older these children in Kinshasa resemble those children with AIDS-related complex reported in the United States. This provides the 1st evidence of HTLV-III/LAV in older children in the developing world and suggests that HTLV-III/LAV infection complicates a substantial proportion of pediatric hospitalizations in Kinshasa Zaire. (authors)