{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:21:41Z","timestamp":1790972501826,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"7027","license":[{"start":{"date-parts":[[1996,2,10]],"date-time":"1996-02-10T00:00:00Z","timestamp":823910400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1995,11,18]]},"published-print":{"date-parts":[[1996,2,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To document the range of disease in African children infected with HIV.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Necropsy results in consecutive children aged 1 month or more who were HIV positive and in children who were HIV negative for comparison; IgA western blots on serum samples from children under 2 years of age who were positive for HIV-1 to test the validity of routine HIV serology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    : Largest hospital in Abidjan, Cote d'Ivoire.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects<\/jats:bold>\n                    : 78 children who were HIV positive and 77 children who were HIV negative on whom a necropsy was performed; their median ages at death were 18 and 21 months respectively. 36 HIV positive children and 29 HIV negative children were 1-14 months old; 42 HIV positive and 48 HIV negative children were &gt;\/=15 months old.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures<\/jats:bold>\n                    : Cause of death and prevalence of diseases confirmed pathologically.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Respiratory tract infections were more common in HIV positive than in HIV negative children (73 (94%) v 52 (68%); P&lt;0.05), and were aetiologically heterogeneous. Pneumocystis carinii pneumonia was found in 11 out of 36 (31%) HIV positive children aged &lt;15 months, but in no HIV negative children. Among older children measles was more common in HIV positive children (8\/42 (19%) v 2\/48 (4%); P&lt;0.06). Pyogenic meningitis was present in similar proportions of HIV positive and HIV negative children aged &lt;15 months (7\/36 (19%) and 7\/29 (24%)). In HIV positive children tuberculosis (1\/78), lymphocytic interstitial pneumonitis (1\/78), and HIV encephalitis (2\/78) were rare.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : There is greater overlap between diseases associated with HIV infection and other common health problems in African children than there is in adults. Compared with adults, HIV positive children had a high prevalence of P carinii pneumonia and a low prevalence of tuberculosis. Measles, but not malaria, was associated with HIV infection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text position=\"float\">\n                      <jats:sec>\n                        <jats:title>Key messages<\/jats:title>\n                        <jats:list list-type=\"bullet\">\n                          <jats:list-item>\n                            <jats:p>Key messages<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>In regions with a poor clinical infrastructure necropsy provides information that cannot be obtained otherwise<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>This survey of children aged under 1 month to 12 years who died in Abidjan, Cote d'Ivoire, found that a fifth were positive for HIV infection with a median age at death of 18 months<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Almost a third of HIV positive children under 15 months old had Pneumocystis carinii pneumonia, a rate similar to that found in affected children in industrialised countries but much higher than the rate in affected adults in Abidjan<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Measles was more common in children who were HIV positive, suggesting that vaccination would be a feasible intervention<\/jats:p>\n                          <\/jats:list-item>\n                        <\/jats:list>\n                      <\/jats:sec>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1136\/bmj.312.7027.335","type":"journal-article","created":{"date-parts":[[2011,10,31]],"date-time":"2011-10-31T14:18:11Z","timestamp":1320070691000},"page":"335-338","source":"Crossref","is-referenced-by-count":132,"title":["Disease in children infected with HIV in Abidjan, Cote d'Ivoire"],"prefix":"10.1136","volume":"312","author":[{"given":"Sebastian B","family":"Lucas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S","family":"Peacock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anatole","family":"Hounnou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Brattegaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouakou","family":"Koffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Honde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Andoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M","family":"De Cock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1996,2,10]]},"reference":[{"key":"2025122308153688000_312.7027.335.1","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1097\/00002030-199101001-00009","article-title":"Global estimates of HIV infections and AIDS cases: 1991.","volume":"5","author":"Chin","year":"1991","journal-title":"AIDS"},{"key":"2025122308153688000_312.7027.335.2","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1097\/00002030-199308000-00027","article-title":"Estimating the rate of mother-to-child transmission of HIV. Report of a workshop on methodological issues, Ghent (Belgium), 17-20 February 1992.","volume":"7","author":"Dabis","year":"1993","journal-title":"AIDS"},{"key":"2025122308153688000_312.7027.335.3","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/00002030-199407000-00019","article-title":"The impact of HIV-1 infection on mortality in children under 5 years of age in sub-Saharan Africa: a demographic and epidemiologic analysis.","volume":"8","author":"Nicoll","year":"1994","journal-title":"AIDS"},{"key":"2025122308153688000_312.7027.335.4","first-page":"S117","article-title":"Natural history and clinical presentation of HIV-1 infection in children.","volume":"5","author":"LePage","year":"1991","journal-title":"AIDS"},{"key":"2025122308153688000_312.7027.335.5","first-page":"1","article-title":"Pediatric AIDS and perinatal infection in Zaire: epidemiologic and pathologic findings.","volume":"3","author":"Nelson","year":"1992","journal-title":"Prog AIDS Pathol"},{"key":"2025122308153688000_312.7027.335.6","first-page":"244","article-title":"Weights of organs of fetuses and infants.","volume":"74","author":"Schulz","year":"1962","journal-title":"Archives of Pathology"},{"key":"2025122308153688000_312.7027.335.7","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1097\/00002030-199009000-00007","article-title":"Rapid and specific diagnosis of HIV-1 and HIV-2 infections: an evaluation of testing strategies.","volume":"4","author":"De Cock","year":"1990","journal-title":"AIDS"},{"key":"2025122308153688000_312.7027.335.8","first-page":"1","article-title":"Revision of the CDC surveillance case definition for AIDS.","volume":"36","year":"1987","journal-title":"MMWR"},{"key":"2025122308153688000_312.7027.335.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470240065034"},{"key":"2025122308153688000_312.7027.335.10","doi-asserted-by":"publisher","DOI":"10.1002\/path.1711700207"},{"key":"2025122308153688000_312.7027.335.11","unstructured":"Kozlowski PB .Pediatric human immunodeficiency virus infection. 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