Severe malnutrition and HIV infection in Burkina Faso

A prospective study in 428 patients aged 4 to 48 months admitted to a pediatric ward in Bobo Dioulasso (Burkina Faso) for marasmus or kwashiorkor found that 60 subjects had a positive serological test (Western Blot) for the human immunodeficiency virus (HIV). Among the 349 subjects older than 12 months, 13.8% were seropositive for the HIV-1 or the HIV-2; in this group, 95.8% of seropositive individuals were infected with the HIV-1. During the same period, none of 135 malnutrition-free controls aged 12 to 48 months had positive serological tests for the HIV. Transmission of the HIV was vertical (mother-to-child) in 77.1% of cases and horizontal in 22.9% of cases (transfusion: 12.5%; multiple parenteral injections: 10.4%). The likelihood of HIV infection was very high among subjects with marasmus, lymphadenopathy and oral candidiasis.