Seroprevalence to human immunodeficiency virus (HIV) was determined among 368 children 2 to 14 years of age who were admitted to the pediatric service at Mama Yemo Hospital in Kinshasa, Zaire. Forty (11%) of these patients and only one (1%) of 92 healthy siblings of these patients were HIV seropositive (x2 = 8.68, P .01). Seropositivity was associated with previous hospitalization, receipt of a blood transfusion prior to the current hospitalization (odds ratio 3.1; 95% confidence interval, 1.5 to 6.4), receipt of medical injections during the past year, and smaller household size. Clinically, HIV seropositivity was associated with the diagnoses of malnutrition and pneumonia. A higher proportion of seropositive children died during the current hospitalization (4/40 v 10/328); when patients with malaria were excluded, the in-hospital mortality of seropositive children was more than eight times higher than that of seronegative children (Fisher exact test, P = .006). Clarification of clinical, immunologic, and epidemiologic features of childhood HIV infection is urgently required because HIV appears to account for or complicate a substantial proportion of pediatric hospitalizations in Kinshasa.
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