Characteristics of children living with HIV in a referral center in Iran: a cross-sectional study

Background. With an estimated 38.4 million people worldwide living with HIV in 2021, including 2.73 million children, there is a pressing need to understand and address HIV transmission and its impact on children’s health. This study aims to describe the demographic characteristics, clinical profiles, and outcomes of Iranian children living with HIV referred to one of the largest center for counseling HIV patients in Iran.

Materials and methods. In this descriptive cross-sectional study, we assessed clinical and biological markers in HIV-infected children treated at the counseling center for behavioral diseases in a referral Hospital in Tehran. The study included a total of 60 records of children and adolescents under the age of 18, spanning from 2004 to 2020. We collected detailed clinical and laboratory data, including demographic information, treatment history, comorbidities, opportunistic infections, adherence to treatment, side effects of HIV treatment, and laboratory test results. Additionally, the study investigated any history of COVID-19 infection during the follow-up period, which coincided with the pandemic.

Results. Out of the 60 patients included in the study, there were 23 females (38.3%) and 37 males (61.6%), with a mean age of 10.03 years. About 16.7% of patients had at least one comorbidity, including epilepsy, ADHD, autoimmune hepatitis, ITP, allergic asthma, alopecia areata, and cystic fibrosis. Among the mothers of these children, 93.9% were HIV-positive. Out of the 60 mothers, 6.7% were not infected with the virus, 60% were receiving treatment, and 10% had passed away. Treatment adherence was acceptable in 93.3% of patients. Opportunistic infectious diseases were experienced by 36.7% of patients, with oral candidiasis being the most common. Hospitalizations occurred in 21 patients, primarily due to pneumonia, fever, weakness, lethargy, and oral thrush.

Conclusions. Investigating the demographic, clinical profile, and long-term outcomes of pediatric HIV is crucial for policymakers to effectively address the ongoing HIV epidemic. Given the significant knowledge gap on pediatric HIV in Iran, further studies in this area are necessary to improve understanding and inform strategies for the prevention, management, and treatment of HIV in children in the country.