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Symptoms of HIV and AIDS

There are numerous symptoms associated with "HIV Infection" and "AIDS" but some of the information about them seems arbitrary or contradictory.

The quotes are classified as:

AIDS in Children

[of 201 children evaluated] 11 children met the criteria of the WHO ['Bangui'] case definition; 9 of them were HIV positive and two were HIV negative. The sensitivity [ability to detect HIV/AIDS] of the case definition…was 14.5%, the specificity was 98.6%, and the positive predictive value (PPV) 81.8%…HIV-positive children did not suffer more frequently from night sweats, comiting, loss of appetite and convulsions than HIV-negative children. They did suffer more frequently from chronic dyspnea [difficulty breathing] and abdominal pain…length, head circumference, and weight of HIV-positive children were more often below the third percentile on the growth charts…marasmus [wasting]…was more frequently seen in the HIV-positive than the HIV-negative group. Furthermore, finger clubbing, delayed development milestones…and hepatosplenomagaly [enlargement of both the liver and spleen] proved a better predictive variable for HIV infection than hepatomegaly or splenomegaly alone [all of these symptoms are compatible with severe malnutrition including various nutritional deficiencies such as rickets]…with its combination of 9 items, dividied into major and minor signs, the WHO case definition was unnecessarily difficult to use in a clinical setting. 6 of the 9 signs had to be obtained from the medical history and could not be objectively verified…[people accompanying the child] were often unable to answer the questions on the duration of certain conditions (i.e. diarrhea, fever, common infections, and could) and the maternal HIV status…The sign 'weight loss of abnormally slow growth' is not clearly defined by the WHO.”
van Gend CL et al. Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa. J Trop Pediatr. 2003 Jun;49(3):143-7.
“The most serious complication of immunization in children with HIV infection, disseminated BCG [Bacille Calmette-Guérin], has been described in numerous case reports…disseminated BCG infection may be indistinguishable from terminal AIDS [i.e. immunization may create a disease that matches the AIDS case definition used in much of the Third World]
Waddell RD et al. Bacteremia due to Mycobacterium tuberculosis or M. bovis, Bacille Calmette-Guérin (BCG) among HIV- positive children and adults in Zambia. AIDS. 2001 Jan 5;15(1):55-60.
“the WHO clinical case definition for paediatric AIDS [2 major signs (weight loss, failure-to-thrive, chronic diarrhoea, prolonged fever) and 2 minor signs (persistent cough, confirmed maternal HIV infection etc.) in the absence of known causes of immunosuppression other than HIV] has yielded less favourable results [than the adult WHO AIDS definition]. For example, among 155 Zairian hospitalized children with a 12% HIV seroprevalence, the sensitivity and PPV [positive predictive value] were only 35% and 25%, respectively. The data presented here from a paediatric hospital-based population with a 15% HIV seroprevalence confirm these previous findings of low sensitivity (41%), low PPV (48%) and a good specificity (92% [although this still means that 8% of children diagnosed with AIDS will not have HIV detectable by antibody tests]).”
Lepage P et al. Evaluation and simplification of the World Health Organization clinical case definition for paediatric AIDS. AIDS. 1989 Apr;3(4):221-5.
“21 (13%) of the 163 children examined [at a hospital in Kinshasa, Zaire] were HIV-seropositive. Four HIV-seropositive children who probably received an HIV-seropositive transfusion…were excluded…Of the remaining 159 children…Documented symptoms and signs that were associated with HIV seropositivity included the following: diarrhea existing for at least 1 month, chronic or recurring otitis [ear infection], generalized lymphadenopathy [swollen lymph nodes], oral candidiasis and hepatosplenomegaly [enlarged liver]. Illness of the mother and presence of HIV-associated symptoms or signs in the mother were also strong associated with HIV seropositivity. The provisional WHO clinical case definition of pediatric AIDS had a specificity of 86%, a sensitivity of 37% and a positive predictive value of 26% for HIV seropositivity”
Colebunders RI et al. Evaluation of a clinical case definition of AIDS in African children. AIDS. 1987 Sep;1(3):151-3.
“P-0 Indeterminate

P-1 Asymptomatic

A-Immune normal

B-Immune abnormalities

C-Not tested

P-2 Symptomatic (not necessarily now)”

CDC. Current trends classification system for Human Immunodeficiency Virus (HIV) infection in children under 13 years of age. MMWR. 1987 Apr 24;36(15):225-30, 235-6.
“Once a child has signs and symptoms and is therefore classified in P-2 [symptomatic HIV infection], he or she should not be reassigned to class P-1 if signs and symptoms resolve.”
CDC. Current trends classification system for Human Immunodeficiency Virus (HIV) infection in children under 13 years of age. MMWR. 1987 Apr 24;36(15):225-30, 235-6.

Courtesy Alberta Reappraising AIDS Society, December 7, 2012.

© Copyright December 7, 2012 by Rethinking AIDS.