Morbidity in HIV-1-Infected Children Treated or Not Treated with Highly Active Antiretroviral Therapy (HAART), Abidjan, Côte d’Ivoire, 2000–04

BACKGROUND: In the 2008 UNAIDS epidemic update 33 million people worldwide were estimated infected with HIV including 2.2 million children. In Cote dIvoire 480000 adults and 60000 children were HIV-infected. Studies in developed countries have shown an improvement of childrens morbidity under HAART treatment. OBJECTIVE: The objective of this study is to describe and compare morbidity in relation to evolution of the disease in HIV-1-infected children in Cote dIvoire according to symptoms and the presence or absence of HAART treatment. METHODOLOGY: A total of 273 HIV-1-infected children from age 18 months to 18 years were included from October 2000 until December 2003. Follow-up was continued until 30 September 2004. The study population was divided in three groups. Group 1 included symptomatic children treated under HAART. Group 2 included asymptomatic children who did not need HAART treatment. Group 3 included children who met criteria to be treated at inclusion but were not treated. PRINCIPAL FINDINGS: The three most common diseases in Group 1 before treatment were bronchitis diarrhoea and ear nose and throat (ENT) diseases. Under treatment the three most common diseases in Group 1 were bronchitis ENT diseases and diarrhoea. The three most occurring diseases in Group 2 were bronchitis ENT diseases and skin infectious diseases. The three most occurring diseases in Group 3 were bronchitis diarrhoea and ENT diseases. CONCLUSIONS: The incidence of diseases was significantly lower among asymptomatic children than among symptomatic untreated children (p < 0.0001). The morbidity found in symptomatic children who received treatment was similar to that encountered in asymptomatic children. The main reason for death in all of the groups was tuberculosis.