Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count

Main Article Content

Archana Mishra
Narendra Nath Soren
Sristi Ganguly


Aims: To study the clinical profile of HIV infected children and correlate them with the CD4 count at the time of presentation.

Study Design: Hospital based observational study

Place and Duration of Study: ART centre of SCBMCH and Department of Pediatrics, SVPPGIP, Cuttack, Odisha during the period October 2017 to September 2019.

Methodology: All children aged between 1.5 to 15 years who were confirmed to be HIV positive by ELISA or immunocomb II, either at present or past were included in the study. They were subjected to CD4 count testing, along with nutritional assessment and screened for opportunistic infections, apart from their socio-demographic details. All quantitative variables including age, weight, height, were compared by unpaired t-test. Categorical variables like sex mode of transmission were compared by chi-square test. Variables like clinical staging, immunological staging and CD4 counts were measured at presentation and analyzed with repeated ANOVA at 5% level of significance to allow for multiple comparisons. P<0.05 was considered significant and inferences were drawn.

Results: Out of 103 cases, majority belonged to age 4- 7 years and 59.2% were malnourished. 24.3% were asymptomatic, with the most common clinical features noted were fever (65%), cough (47.8%), recurrent diarrhoea (41.8%) and weight loss (40.8%). The incidence of opportunistic infections was 24.3%, with tuberculosis (40%) and herpes zoster (36%) leading the list. Most cases (37.87%) came under WHO clinical stage-III. A significant correlation was found between CD4 count and age, WHO clinical staging, opportunistic infections in the population. Lower CD4 counts were associated with younger age, lower staging and less risk for symptoms and infections.

Conclusion: CD4 count is a reliable market to assess the staging and risk for opportunistic infections in pediatric HIV and thus can be used as screening tool for complications/ deterioration in the child, for better management.

HIV, CD4 count, clinical profile, opportunistic infections.

Article Details

How to Cite
Mishra, A., Soren, N. N., & Ganguly, S. (2020). Study of Clinical Manifestations of HIV Infected Children in Relation to CD4 Count. Asian Journal of Pediatric Research, 4(2), 1-8.
Original Research Article


Paranjpe SM, Sarkate PP, Ingole NA, Raut SS, Mehta PR. Profiles of HIV-infected anti retro viral therapy naïve children from Mumbai, India World J Pediatr. 2016;12(4):430-435

Ramaswamy S, Thandavarayan M, Thirumalaikuruswamy S, Sureshkumar A. A study on clinical profile of paediatric HIV infection in the age group of 18 months to 12 years and its correlation with CD4 count, Int J Contemp Pediatr. 2017;4:1232-1235

Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO). AIDS epidemic update: December 2003. UNAIDS, WHO; 2003.

WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV related disease in adult and children. WHO; 2006.

Available: staging150307.pdf

Accessed September 18, 2018

Gupta P, Shah D. Protein Energy Malnutrition. In: Ghai OP, Gupta P, Paul VK, editors. Ghai Essential Pediatrics. 6th ed. New Delhi: CBS Publishers & Distributors. 2004;101-118.

Agarwal D, Chakravarty J, Sundar S, Gupta V, Bhatia BD. Correlation between clinical features and degree of immunosuppression in HIV infected children. Indian Pediatr. 2008;45(2):140-3.

Shah I. Correlation of CD4 count, CD4% and HIV viral load with clinical manifestations of HIV infected Indian children. Ann Trop Pediatr. 2006;26:115-119.

De Onis M, Blössner M. WHO global database on child growth and malnutrition. WHO/NUT/97.4. Geneva: World Health Organization; 1997.

Joint United Nations program on HIV/AIDS (UNAIDS)/WHO. AIDS epidemic update; 2006.

Available: Publications/default.asp

Accessed on 1 October 2007

Attili SVS, Singh VP, Rai M, Varma DV, Gulati AK, Sundar S. Hematological profile of HIV patients in relation to immune status- A hospital based cohort from Varanasi, North India.Turk J Haematol. 2008;25(1): 13-19.

Swetha GK, Hemalatha R, Prasad UV, Murali V, Damayanti K, Bhaskar V. Health and nutritional status of HIV infected children in Hyderabad, India. Indian J Med Res. 2015;141(1):46–54.

Lodha R, Singhal T, Kabra SK. Pediatric HIV infection: Clinical manifestation and diagnosis. Ann Natl Acad Mcd Sci (India). 2000;36:75-82.

Gomber S, Kaushik JS, Chandra J, Anand R. Profile of HIV infected children from Delhi and their response to ART. Indian Pediatr. 2011;48:703-707.

Padmapriyadarsini C, Pooranagangadevi NP, Chandrasekaran K, Subramanyan S, Thiruvalluvan C, Bhavani PK, Swaminathan S. Prevalence of Under-weight, Stunting, and Wasting among Children Infected with Human Immuno-deficiency Virus in South India. International Journal of Pediatrics; 2009.


Pol RR, Shepur TA, Ratageri VH. Clinico-Laboratory Profile of pediatric HIV in Karnataka. Indian J Pediatr. 2007;74(12): 1071-5.

Joint United Nations Program on HIV/AIDS (UNAIDS)/WHO AIDS epidemic update 2012.