Morbidity in HIV-1-Infected children treated or not treated with highly active antiretroviral therapy (HAART), Abidjan, Cote d'Ivoire, 2000-04.

Background: In the 2008 UNAIDS epidemic update, 33 million people worldwide were estimated infected with HIV, including 2.2 million children. In Côte d'Ivoire, 480,000 adults and 60,000 children were HIV-infected. Studies in developed countries have shown an improvement of children's morbidity under HAART treatment.
Objective: The objective of this study is to describe and compare morbidity in relation to evolution of the disease in HIV-1-infected children in Côte d'Ivoire, according to symptoms and the presence or absence of HAART treatment.
Methodology: A total of 273 HIV-1-infected children from age 18 months to 18 years were included from October 2000 until December 2003. Follow-up was continued until 30 September 2004. The study population was divided in three groups. Group 1 included symptomatic children treated under HAART. Group 2 included asymptomatic children who did not need HAART treatment. Group 3 included children who met criteria to be treated at inclusion but were not treated.
Principal Findings: The three most common diseases in Group 1 before treatment were bronchitis, diarrhoea and ear nose and throat (ENT) diseases. Under treatment, the three most common diseases in Group 1 were bronchitis, ENT diseases and diarrhoea. The three most occurring diseases in Group 2 were bronchitis, ENT diseases and skin infectious diseases. The three most occurring diseases in Group 3 were bronchitis, diarrhoea and ENT diseases.
Conclusions: The incidence of diseases was significantly lower among asymptomatic children than among symptomatic untreated children (p < 0.0001). The morbidity found in symptomatic children who received treatment was similar to that encountered in asymptomatic children. The main reason for death in all of the groups was tuberculosis.