Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
Indian J Sex Transm Dis
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Year : 2009  |  Volume : 30  |  Issue : 2  |  Page : 79-83

Papular pruritic eruptions: A marker of progressive HIV disease in children: Experience from eastern India

Department of Pediatric Medicine, Medical College and Hospital, Kolkata, India

Correspondence Address:
Moumita Samanta
123/1/6, Roy Bahadur Road, Behala, Kolkata - 700 034
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0253-7184.62762

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Context: Papular pruritic eruptions (PPEs) are a commonly seen dermatological manifestation in children with Human Immunodeficiency Virus (HIV) stage 2 disease, whereas recurrent upper respiratory tract infection (URTI) (>2 episodes in 6 months) is the most common presenting illness in this category. Papular pruritic eruptions has been associated with progressive HIV disease in adults though it is categorized in early stage. Aim: To evaluate PPE as a clinical marker for progressive pediatric HIV. Setting and Design: In Pediatric HIV/AIDS clinic, Medical College, Kolkata, a prospective longitudinal hospital-based observational study was carried out. Materials and Methods: A total of 108 children in WHO stage 2 HIV disease aged between 2 and 12 years were selected, of which 58 had recurrent URTI without PPE and another 50 had PPE with or without secondary bacterial infection. Clinico-immunological deterioration was compared between the groups in terms of progression to undernutrition, WHO clinical stage 4 disease, severe immunodeficiency, need for initiation of Highly Active Anti Retroviral Therapy (HAART) and mortality over a period of 2 years. Statistical Analysis: SPSS statistical software version 10 was used. P value, relative risk (RR) with 95% Confidence Interval (CI), sensitivity and specificity was estimated. P < 0.05 was considered significant. Results: Significantly higher incidence (P < 0.001) of clinico-immunological progression of disease at a significantly shorter time period (P < 0.05) was found in those with PPE in comparison to those without PPE. Papular pruritic eruption has high sensitivity, specificity and positive predictive value as a clinical marker for severe immunodeficiency. Conclusion: Papular pruritic eruption could be a useful clinical marker of progressive HIV disease in children.

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