Atopy in HIV-infected children in Pretoria

Abstract

Introduction

The development or aggravation of a pre-existing atopic state and Human Immunodeficiency Virus (HIV) has not been thoroughly investigated in South Africa. HIV-infected adults have a higher prevalence of atopy in some international studies but this has not been documented in children.

Methodology

A prospective convenience sample study of 50 children aged between 3 months and 12 years of age, attending the HIV clinic in Pretoria, South Africa were recruited. Their personal and family histories of atopy and World Health Organisation (WHO) HIV clinical staging and Centre for Disease Control (CDC) immunological staging with CD4 counts were documented. An age and sex-matched control group of 50 HIV-negative children were included as a control group. Spin prick tests (SPT) to identify common aeroallergens were conducted in all subjects.

Results

100 children were enrolled with 50 in each group. 10% of the HIV-infected patients in comparison to 16% of controls had positive SPT to aeroallergens. Of the HIV infected patients more had chronic rhinitis and eczema (60% and 68% respectively). There was no relationship between CD4 count and any SPT positivity (p=0.61), Mean log CD4 count and presence of reported asthma (p=0.71), and CD4 count and reported presence of dermatitis (p=0.84). CD4 count was not statistically different between children with and without family history of atopy (p=0.68).

Conclusion

It appears that the stage of HIV disease does not influence the development or expression of allergy. There is a high prevalence of dermatitis and chronic rhinitis in HIV-infected children, probably not atopic in origin.