Pneumonia Mortalities Elevated in HIV-infected Children

Children who are HIV-positive have a mortality rate 6 times higher than children without the virus, according to an article published online in The Lancet.

Though pneumonia is recognized as the leading cause of death in children globally, the study is the first to analyze the effects of pneumonia on HIV-positive children on a worldwide and by country basis, a statement released by the Universityof Edinburgh pointed out.

The study was authored by researchers from the University of Edinburgh who projected 2010 pneumonia cases and deaths in HIV-infected children 5 years or younger living in 133 high pneumonia-burden countries.

In doing so, the investigators discovered pneumonia mortalities of children with HIV versus children without HIV were significantly higher (OR 5.9, 95% CI 2.7—12.7). Furthermore, the scientists noted their hospitalization odds were also elevated compared to their uninfected counterparts.

“Of these, 1.2 million pneumonia episodes (UR 0·5 million—2.7 million) and 85,400 deaths (UR 46 000–147 300) were directly attributable to HIV. 1.3 million (90%) pneumonia episodes and 82,400 (93%) pneumonia deaths in HIV-infected children aged younger than 5 years occurred in the WHO African region,” the writers penned.

While pneumonia-associated mortalities among HIV-infected children are rare on a worldwide scale, the investigators pointed out that in “the highest HIV-burden countries in sub-Saharan Africa (i.e., Swaziland, Lesotho, and Zimbabwe), up to a fifth of all pneumonia cases and 60% of pneumonia deaths occur in HIV-infected children.”

In light of their findings,the writers urged overhauling medical care in high-risk counties by increasing availability to antiretroviral drugs and proactive testing.

“Pneumonia management in HIV infected children requires an integrated approach from national governments and international agencies,” lead researcher, Dr. Harish Nair, urged in the release. Nair continued, “Revised guidelines by the World Health Organization (WHO) for childhood pneumonia management must be fully implemented if substantial falls in pneumonia morbidity and mortality are to be achieved in badly affected countries."