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0SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 3 ISSUE 7 JULY 2024 ISSN: 2181-3337 | SCIENTISTS.UZ
HIV IN CHILDREN: MANIFESTATIONS OF DIARRHOEAL
SYNDROME
Bolunts E.A.
Student of Tashkent Medical Academy https://doi. org/10.5281/zenodo. 13123163
Abstract. The article is devoted to the manifestations of HIV infection in children, and the peculiarities of diarrhea syndrome. The article presents data on HIV manifestations in children, clinical pictures, features of diarrhea syndrome, and its frequency of occurrence. Thus, there were significant differences in diarrhea in HIV-infected children in terms of the following characteristics: the presence of dehydration and its severity, the frequency of diarrhea episodes per day, the number of diarrhea episodes per child, and the frequency of diarrhea episodes per child.
Keywords: human immunodeficiency virus (HIV), antiretroviral therapy (ART), children, undetectable viral load level (UVL), AIDS (Acquired Immunodeficiency Syndrome).
Relevance. Today in our republic more than 48 thousand people live with HIV/AIDS. Of these, 54% are men, 46% are women. According to last year's data, the number of infected people in Uzbekistan was 45 thousand. Of these, 55% were men, 45% were women and 14% were children under 18 years old.
Also last year, due to internal migration and a large population, the HIV/AIDS infection rate was high in the city of Tashkent and Tashkent region.
According to HIV/AIDS statistics for the period from 2013 to 2022, in 2020 this disease was diagnosed in 2817 people, in 2021 - in 3289, in 2022 - in 3889 people.
It should be said that over the past 5 years, the number of tests for HIV/AIDS has increased from 700 thousand to 3.5 million, or 5 times. Government funding for medicines is 80%.
HIV infection in children can manifest with various clinical symptoms that depend on the stage of the disease. In the initial stages, the infection may be asymptomatic, but as the disease progresses, manifestations may occur.
Clinical manifestations of HIV infection in children
1- Acute stage of infection:
- Fever
- Enlargement of lymph nodes
- Nausea and vomiting
- Fatigue
2. Chronic stage:
- Chronic diarrhea
- Frequent infections (pneumonia, fungal infections)
- Delayed growth and development
- Enlargement of the liver and spleen
3. AIDS stage (Acquired Immunodeficiency Syndrome):
- Cough that does not go away
- Weight wasting
- Opportunistic infections (e.g., pneumocystis pneumonia)
SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 3 ISSUE 7 JULY 2024 ISSN: 2181-3337 | SCIENTISTS.UZ
- Decreased CD4-lymphocyte counts
Diarrhea can be a prominent symptom in children with HIV infection. It can occur for several reasons:
-Infectious causes (bacterial, viral, fungal infections).
-Opportunistic infections such as cryptosporidiosis or infection caused by cytomegalovirus.
-Side effects of antiretroviral therapy.
- Intolerance to certain foods or substances.
Diarrhea in HIV infection can lead to severe dehydration and nutrient deficiencies, which is important to consider in treatment. Prevention and timely treatment of diseases and management of symptoms, including diarrhea, are critical to keeping children with HIV infection healthy.
Acute diarrhea affects up to 1.4 billion children under 5 years old worldwide each year, of whom 123 million require emergency treatment, 9 million require hospital care, and 1.8 million children die from dehydration. Diarrhea in children can be watery (acute gastroenteritis, as defined by ESPGHAN) and mucous-bloody (colitis, enterocolitis). The frequency of acute infectious diarrhea in children of the first 3 years in European countries is 0.5-1.9 episodes per year [1, 2].
To date, the spectrum of infectious diarrhea pathogens has been established and sufficiently characterized, which can be caused by many viral (rotaviruses, noroviruses, adenoviruses, etc.), bacterial (shigella, salmonella, E. coli, St. aureus, etc.) and parasitic agents (Cryptosporidium parvum, Cystoisospora belli, etc.) [3-1 2].
In HIV-infected patients, the mucosa of the gastrointestinal tract is both the entry gate and the site of clinical manifestations of many opportunistic and non-opportunistic infections and tumors. The leading symptom in this form of AIDS is persistent or recurrent diarrhea with progressive weight loss, dehydration, and intoxication [7, 9, 11]. It occurs in 30-50% of patients from developed countries and in 90% of patients from developing countries. The mechanism of diarrhea development in AIDS patients is associated with atrophy of intestinal mucosal villi and increased permeability of the intestinal wall. Increased intestinal wall permeability leads to antigens penetration through it and increased release of various inflammatory mediators. These disorders may be associated with immunological changes in lamina propria lymphocytes caused by HIV, or they may develop during an infectious process in the intestine.
All young children are vulnerable to acute intestinal infections, but children living with HIV are more affected by diarrhea because they are infected with a wider range of pathogens and have more severe manifestations of infection [7, 9, 13]. Diarrhea is a major predictor of HIV in children. The severity of diarrhea varies widely according to fluid losses, of particular importance is the accuracy of assessing the degree of dehydration in a child. The presence of blood in the stool is also among the indicators of diarrheal disease severity.
Earlier studies by L.N. Tuichieva, G.K. Khudaykulova, Sh.B. Rakhmatullaeva and M.T. Muminova reported that the majority of observed children (77%) with HIV infection were older than 3 years. In 86.5% of cases, the HIV infection was in stage II or III. Children with HIV infection have longer and more severe diarrhoea. Signs of dehydration were found in 70.5% of the children in the main group and in 50.6% of the children in the comparison group, but severe dehydration was 2.6 times more common in children with HIV infection (18.8% and 7.3% of cases, respectively, P < 0.05). The degree of dehydration was influenced by the number of diarrhea episodes per day and their duration. Prolonged diarrhea was significantly more frequent in the
SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 3 ISSUE 7 JULY 2024 ISSN: 2181-3337 | SCIENTISTS.UZ
main group of children, with a duration of 6-9 days being 1.7 times more frequent (56.3% and 32.8% of cases, respectively, P < 0.05) and 10-14 days being more frequent (11.9% and 5.7% of cases, respectively, P < 0.05). Diarrhea with more than 15 episodes per day was 2.2 times more frequent in the main group than in the comparison group (37.9% and 17.4% of cases, respectively, P < 0.05). Children in the main group were 1.5 times more likely to have watery stools (39.5% vs. 25.9% of cases, P < 0.05), foul-smelling stools (45.2% vs. 29.1% of cases, P < 0.05), and greenish stools (58.6% vs. 37.2% of cases, P < 0.05).
Pathological inflammatory contamination of faces in the form of blood was 3.0 times more frequent in the main group (37.5% and 12.6% of cases, respectively, P < 0.05), and pus was 2.6 times more frequent (59.8% and 23.1% of cases, respectively, P < 0.05).
Conclusion. Thus, there were significant differences in diarrhea in HIV-infected children in terms of the following characteristics: the presence of dehydration and its severity, the frequency of diarrhea episodes per day, the number of diarrhea episodes per child, and the frequency of diarrhea episodes per child.
REFERENCES
1. Kamenju P., E. Liu, E. Hertzmark, D. Spiegelman, R.R. Kisenge, R. Kupka, S. Aboud, K.P. Manji, C. Duggan, W.W. Fawzi Complementary Feeding and Diarrhea and Respiratory Infection Among HIV-exposed Tanzanian Infants. J Acquir Immune Defic Syndr. 2017; 74(3):265-272
2. United Nations inter-agency group for child mortality estimation. Levels and Trends in Child Mortality. United Nations: Joint WHO, UNICEF, World Bank Group, UN-DESA Population Divi si on Report; 2015.
3. World Gastroenterology Organization (2012). Acute diarrhea in adults and children: a global perspective. (Milwaukee, WI, USA: World Gastroenterology Publication;) 53202—3823.
4. ВОЗ: ВИЧ и дети
5. Ганиева С., Рахматуллаева Ш. Б., Худайкулова Г. К. Влияние пробиотиков на суточную диарею у детей с ОКИ : дис. - Россия, Санкт-Петербург, 2022.
6. Даминов Т. О. и др. Роль аллельных и генотипических вариантов полиморфного маркера CCR5 -DELTA32 в формировании устойчивости к вич инфекции. - 2020.
7. Милицкая М. А. ЗАБОЛЕВАЕМОСТЬ ВИЧ-ИНФЕКЦИЕЙ ДЕТЕЙ И ПОДРОСТКОВ //Университетская наука: взгляд в будущее. - 2020. - С. 556-558.
8. Муминова М. Т., Рахматуллаева Ш. Б., Садиков Х. М. А. ОИВ -инфекцияли болаларда диарея синдромини даволаш самарадорлиги : дис. - 2023.
9. Нарзуллаев Н. У., Ихтиярова Г. А., Олимова Н. И. КЛИНИКО -ЭПИДЕМИОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА ВИЧ-ИНФИЦИРОВАННЫХ ДЕТЕЙ РОДИВШИХСЯ ОТ ВИЧ-ИНФИЦИРОВАННЫХ МАТЕРЕЙ //Новый день в медицине. - 2020. - №. 1. - С. 295-297.
10. Налимова Т. М. и др. РАСПРОСТРАНЕНИЕ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТИ ВИЧ-1 СРЕДИ ВИЧ-ИНФИЦИРОВАННЫХ ДЕТЕЙ НОВОСИБИРСКОЙ ОБЛАСТИ, АЛТАЙСКОГО И КРАСНОЯРСКОГО КРАЯ //ОХРАНА ЗДОРОВЬЯ МАТЕРИ И РЕБЕНКА. - 2022. - С. 154.
SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 3 ISSUE Т JULY 2024 ISSN: 2181-333Т | SCIENTISTS.UZ
11. Aбдyллаев, Р. Н., Aбдyллаева, M. А., & Собирова, М. Р. (2018). Интраоперационный метод лечения и профилактики спаечной болезни малого таза y пациенток с тру6но -перитонеальным бесплодием. Москва. Проблемы науки,(11), 35.
12. Зияева, Э. Р., Рузиева, Н. Х., & Собирова, М. Р. К. (2022). СИНДРОМ ХРОНИЧЕСКОЙ ТАЗОВОЙ БОЛИ ПРИ ХРОНИЧЕСКОМ САЛЬПИНГООФОРИТЕ-СОВРЕМЕННЫЙ ВЗГЛЯД НА ПАТОГЕНЕЗ. Re-health journal, (2 (14)), 1-5.
13. Зияева, Э. Р., Абдуллаев, Р. Н., & Собирова, М. Р. (2018). ИЗМЕНЕНИЕ НЕСПЕЦИФИЧЕСКИХ ФАКТОРОВ ЗАЩИТЫ БОЛЬНЫХ ХРОНИЧЕСКИМ САЛЬПИНГООФОРИТОМ ПОД ДЕЙСТВИЕМ КОМПЛЕКСНОЙ ФИЗИЧЕСКОЙ РЕАБИЛИТАЦИИ. In Молодежь-практическому здравоохранению (pp. 415-418).
14. Alieva, M. A., & Sobirova, M. R. (2023). JINSIY A'ZOLAR PROLAPSI BO'LGAN AYOLLARNI JARROHLIK YO'LI BILAN DAVOLASHNI SAMARADORLIGI. Евразийский журнал медицинских и естественных наук, 3(4 Part 2), 65-70.
15. Нигматова, Г. М., & Кочиева, А. М. (2023). Влияние гистерэктомии в репродуктивном возрасте на качество жизни женщин (Doctoral dissertation, Современные подходы к стандартизации оказания медицинской помощи в акушерско-гинекологической практике).
16. Мохира, Т. (2015). ЖАНРА РАССКАЗА С ТОЧКИ ЗРЕНИЯ ИССЛЕДОВАТЕЛЕЙ И ЕГО ПРИМЕНЕНИЕ В ДЕТСКОЙ ЛИТЕРАТУРЕ. Вестник Таджикского национального университета. Серия филологических наук, (4-5), 201-206.
17. Zufarova, S., & Turakulova, S. (2024). WAYS TO CORRECT MENSTRUAL DYSFUNCTION IN WOMEN WITH OBESITY. Science and innovation, 3(D5), 527-531.
18. Рахматуллаева Ш. Х. Эволюции развития концепции важных показателей эффективности (KPI) трудовой деятельности и виды современной оценки //" Экономика и туризм" международный научно-инновационной журнал. - 2023. - Т. 4. -№. 12.
19. Савченко Н. В. и др. Разработка мобильного сервиса в сфере здравоохранения для детей, живущих с ВИЧ //Уральский медицинский журнал. 2020.№ 12 (195). - 2020.
20. Серикова Е. Н., Щемелев А. Н., Останкова Ю. В. МУТАЦИИ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТИ ВИЧ У ДЕТЕЙ, УЧАСТВОВАВШИХ В ПРОГРАММЕ ПРОФИЛАКТИКИ ПЕРЕДАЧИ ВИРУСА ОТ МАТЕРИ К РЕБЕНКУ //АКТУАЛЬНЫЕ ВОПРОСЫ ВИЧ-ИНФЕКЦИИ. ОХРАНА ЗДОРОВЬЯ МАТЕРИ И РЕБЕНКА. - 2021. - С. 198-199.
21. Туйчиев Л. Н. и др. Сравнительный анализ клиники и течения острых диарей у детей при ВИЧ-инфекции //Детские инфекции. - 2023. - Т. 22. - №. 2 (83). - С. 34-38.
22. ЮНЭЙДС: Дети и ВИЧ
23. Уфимцева М. А. и др. Особенности микробиоты кожи у ВИЧ -инфицированных детей //Уральский медицинский журнал. 2020.№ 4 (187). - 2020.
