Incidence and clinical manifestations of HIV-1 infection in multitransfused thalassaemic Indian children

Four hundred and six multitransfused thalassaemic children attending the paediatric clinic in Manipur, India, were screened for HIV antibodies. There were 46 (8.9%) ELISA antibody-positive children and the diagnosis was reaffirmed by Western blot assay. The immunologic status of the seropositive children was evaluated by a) absolute lymphocyte count, b) percentage of ratio of T helper (CD4+) and T suppressor (CD8+) cells, c) quantitative Ig, G, M and A levels and d) delayed-type cutaneous hypersensitivity (DTH) testing. Twelve of the 36 seropositive children were clinically symptomatic with AIDS. The clinical and immunological status of seropositive children are compared with matched seronegative thalassaemic control groups. Five of the 12 symptomatic seropositive children had received continued antiretroviral treatment. The mortality rate at the end of 36 weeks of itinerary was 20% in contrast to 50% in the untreated children. This report highlights the value of early recognition and therapeutic intervention in a selected high risk paediatric population.