Otorrhoea is a marker for symptomatic disease in HIV-infected children

Background. Chronic otorrhoea occurs commonly in HIV-infected children. However, there are few data on incidence and severity. Objective. To document the prevalence of otorrhoea in the clinic attendees. Methods. A retrospective chart review was done of all HIV-I infected children seen at the Family Clinic for HIV from 1 February 1997 to 31 December 2001, a period preceding widespread availability of antiretrovirals. Otorrhoea was classified into two groups, viz. group 1 (mild): an episode lasting less than 1 month, and group 2 (severe): an episode lasting more than 1 month or more than 1 episode of otorrhoea. The clinical and immune stages of the children were noted. Results. Of 326 children seen during the study period, 104 (32%) had otorrhoea. Forty-five (13.8%) had mild and 59 (18.1%,) severe otorrhoea. Two hundred and eighty-eight (88.6'%) had either Centers for Disease Control stage B or C disease. The median CD4 percentage in children with otorrhoea was 17.5% (8.3 - 23%) versus 21% (14 - 28%) in those without otorrhoea (p=0.004). The odds ratio (OR) of children in stage B or C not having severe otorrhoea was 0.1 (0.01 - 0.72, p = 0.013). The OR for immune class 2 or 3 without severe otorrhoea was 0.39(0.18 - 0.85, p=0.021). Conclusions. Otorrhoea contributes to the morbidity of HIV infection in children. It is a marker for symptomatic disease and CD4 depletion and should be included in clinical classifications.