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Iron supplementation for reducing morbidity and mortality in children with HIV

  1. Ifedayo Adetifa1,*,
  2. Uduak Okomo2

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 29 SEP 2008

DOI: 10.1002/14651858.CD006736.pub2


How to Cite

Adetifa I, Okomo U. Iron supplementation for reducing morbidity and mortality in children with HIV. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD006736. DOI: 10.1002/14651858.CD006736.pub2.

Author Information

  1. 1

    Medical Research Council (UK) Laboratories, Bacterial Diseases Programme, Banjul, Gambia

  2. 2

    Medical Research Council (UK), Viral Diseases Programme, Fajara, Gambia

*Ifedayo Adetifa, Bacterial Diseases Programme, Medical Research Council (UK) Laboratories, Atlantic Boulevard, Fajara, PO Box 273, Banjul, Gambia. iadetifa@mrc.gm. ifedayoadetifa@yahoo.co.uk.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 21 JAN 2009

SEARCH

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Jacobus 1996Clinical trial, no randomization, unplanned controlled trial, not in children

Olsen 2004Not a RCT: post-hoc analysis of results from a RCT of iron supplementation done on adults and children. HIV status was not identified at onset of study. HIV testing and viral load were conducted anonymously on samples archived at 4-month follow-up in the original trial. No HIV testing or viral load assessments were done on samples of the children recruited.

Olsen 2006RCT of iron supplementation in a mixed adult and children population: HIV status not determined at onset but on a sample of archived adult samples collected at 4-month follow-up. Primary outcomes were blood haemoglobin and serum ferritin.

Semba 2007Clinical trial of iron and other micronutrients in HIV and Hepatitis C infected female injection drug users

 
Summary of findings for the main comparison. Centers for Diseases Control and Prevention: HIV Paediatric Clinical Categories

Category NCategory ACategory BCategory C

Children who are asymptomatic of HIV infection or who have only one Category A conditionChildren with 2 or more of the following conditions and no Category B or C conditionChildren who are symptomatic and have conditions like below other than those in Categories A or CSerious bacterial infections, multiple or recurrent (e.g. any combination of at least 2 culture-confirmed infections within a 2-year period), of the following types: septicaemia, pneumonia, meningitis, bone or joint infection, or abscess of an internal organ or body cavity (excluding otitis media, superficial skin or mucosal abscesses, and indwelling catheter-related infections)

-Lymphadenopathy (>0.5cm at >2 sites; bilateral= 1 site)Anaemia (<8g/dL), neutropenia (<1000/mm3), or thrombocytopenia (<100 000/mm3) persisting >30 daysCandidiasis, oesophageal, or pulmonary (bronchi, trachea, lungs)

-HepatomegalyBacterial meningitis, pneumonia, or sepsis (single episode)Coccidiodomycosis, disseminated (at site other than or in addition to lungs or cervical or hilar lymph nodes)

-SplenomegalyCandidiasis, oropharyngeal (e.g. thrush) persisting for >2 months in children >6 monthsCryptococcosis, extrapulmonary

-DermatitisCardiomyopathyCryptosporidiosis or isosporiasis with diarrhoea persisting >1 month

-ParotitisCytomegalovirus (CMV) infection with onset before age 1 monthCMV disease with onset of symptoms at age >1 month (at a site other than liver, spleen, or lymph nodes)

-Recurrent or persistent upper respiratory infection, sinusitis, or otitis mediaDiarrhoea, recurrent or chronicEncephalopathy (at least 1 of the following progressive findings present for at least 2 months in the absence of concurrent illness other than HIV infection that could explain the findings): a) failure to attain or loss of developmental milestones or loss of intellectul ability, verified by standard developmental scale or neuropsychological tests; b) impaired brain growth or acquired microcephaly demonstrated by head circumference measurements of brain atrophy demonstrated by CT or MRI (serial imaging is required for children age <2 years); c) acquired symmetric motor deficit manifested by 2 or more of the following: paresis, pathologic reflexes, ataxia, or gait disturbance

HepatitisHerpes simplex virus (HSV) causing a mucocutaneous ulcer that persists for >1 month or bronchitis, pneumonitis, or oesophagitis for any duration affecting a child aged >1 month

HSV stomatitis, recurrent (e.g. >2 episodes within 1 year)Histoplasmosis, disseminated (at site other than or in addition to lungs or cervical or hilar lymph nodes)

HSV bronchitis, pneumonitis, or oesophagitis with onset before age 1 monthKaposi's sarcoma

Herpes zoster (e.g. shingles) involving at least 2 distinct episodes or more than one dermatomeLymphoma, primary, in brain

LeiomyosarcomaLymphoma, small, noncleaved cell (Burkitt's), or immunoblastic or large cell lymphoma of B cell or unknown immunologic phenotype

Lymphoid interstitial pneumonia (LIP) or pulmonary lymphoid hyperplasia complexPneumocystis carinii pneumonia (PCP)

NephropathyProgressive multifocal leukoencephalopathy (PML)

NocardiosisSalmonella (nontyphoid) septicaemia, recurrent

Fever lasting >1 monthToxoplasmosis of the brain with onset at age >1 month

Toxoplasmosis with onset before age 1 monthMycobacterium tuberculosis, disseminated or extrapulmonary Mycobacterium, other species or unidentified species, disseminated (at site other than or in addition to lungs, skin, or cervical or hilar lymph nodes)

Varicella, disseminated (e.g. complicated chickenpox)Mycobacterium avium complex or Mycobacterium kansasii, disseminated (at site other than or in addition to lungs, skin, cervical or hilar lymph nodes)

 
Table 1. PUBMED search strategy

SearchSearch termsResults

#1Search HIV Infections[MeSH] OR HIV[MeSH] OR hiv[tw] OR hiv-1*[tw] OR hiv-2*[tw] OR hiv1[tw] OR hiv2[tw] OR hiv infect*[tw] OR human immunodeficiency virus[tw] OR human immunedeficiency virus[tw] OR human immuno-deficiency virus[tw] OR human immune-deficiency virus[tw] OR ((human immun*) AND (deficiency virus[tw])) OR acquired immunodeficiency syndrome[tw] OR acquired immunedeficiency syndrome[tw] OR acquired immuno-deficiency syndrome[tw] OR acquired immune-deficiency syndrome[tw] OR ((acquired immun*) AND (deficiency syndrome[tw])) OR "sexually transmitted diseases, viral"[MESH:NoExp]228146

#2Search randomized controlled trial [pt] OR controlled clinical trial [pt] OR randomized controlled trials [mh] OR random allocation [mh] OR double-blind method [mh] OR single-blind method [mh] OR clinical trial [pt] OR clinical trials [mh] OR ("clinical trial" [tw]) OR ((singl* [tw] OR doubl* [tw] OR trebl* [tw] OR tripl* [tw]) AND (mask* [tw] OR blind* [tw])) OR ( placebos [mh] OR placebo* [tw] OR random* [tw] OR research design [mh:noexp] OR (comparative study) OR (comparative studies) OR (evaluation studies) OR follow-up studies [mh] OR prospective studies [mh] OR control* [tw] OR prospectiv* [tw] OR volunteer* [tw]) NOT (animals [mh] NOT human [mh])3697500

#3Search (FERROUS SALT) OR (FERROUS SALT) OR (FERROUS GLUCONATE) OR (FERROUS SULPHATE) OR (FERROUS LACTATE) OR (FERROUS FUMARATE) OR (IRON AMINO ACID CHELATE) OR (FERROUS SULFATE) OR (IRON DEXTRAN) OR (IRON SORBITOL) OR (IRON SUCROSE) OR (SODIUM FERRIC GLUCONATE) OR (IRON-POLYSACCHARIDE) OR (IRON POLYSACCHARIDE) OR FERROUS COMPOUNDS[MH:EXP] OR IRON COMPOUNDS[MH:EXP] OR (IRON-DEXTRAN COMPLEX) OR FERRIC COMPOUNDS[MH:EXP]36706

#4Search (IRON SUPPLEMENTATION) OR (IRON DEFICIENCY) OR (IRON AND (DIETARY SUPPLEMENTS[MH])) OR (SUPPLEMENTARY IRON) OR (IRON DEFICIENCY ANEMIA) OR (IRON-DEFICIENCY ANEMIA) OR (IRON DEFICIENCY ANEMIAS) OR (IRON-DEFICIENCY ANEMIAS) OR (IRON DEFICIENCY ANAEMIA) OR (IRON-DEFICIENCY ANAEMIA) OR (IRON DEFICIENCY ANAEMIAS) OR (IRON-DEFICIENCY ANAEMIAS) OR ANEMIA, IRON-DEFICIENCY[MH]18407

#5Search #3 OR #452575

#6Search #1 AND #2 AND #5 Limits: Publication Date from 1980 to 200889

 
Table 2. EMBASE search strategy

SearchSearch termsResults

#1iron supplementation' OR (('iron deficiency'/exp OR 'iron deficiency') OR ('iron deficiency'/de OR 'iron deficiency')) OR ((('iron'/exp OR 'iron') OR ('iron'/de OR 'iron')) AND (('dietary supplements'/exp OR 'dietary supplements') OR ('dietary supplements'/de OR 'dietary supplements'))) OR 'supplementary iron' OR (('iron deficiency anemia'/exp OR 'iron deficiency anemia') OR ('iron deficiency anemia'/de OR 'iron deficiency anemia')) OR (('iron-deficiency anemia'/exp OR 'iron-deficiency anemia') OR ('iron-deficiency anemia'/de OR 'iron-deficiency anemia')) OR 'iron deficiency anemias' OR 'iron-deficiency anemias' OR (('iron deficiency anaemia'/exp OR 'iron deficiency anaemia') OR ('iron deficiency anaemia'/de OR 'iron deficiency anaemia')) OR (('iron-deficiency anaemia'/exp OR 'iron-deficiency anaemia') OR ('iron-deficiency anaemia'/de OR 'iron-deficiency anaemia')) OR 'iron deficiency anaemias' OR 'iron-deficiency anaemias' OR (('anemia iron-deficiency'/exp OR 'anemia iron-deficiency') OR ('anemia iron-deficiency'/de OR 'anemia iron-deficiency'))22381

#2'ferrous salt' OR (('ferrous gluconate'/exp OR 'ferrous gluconate') OR ('ferrous gluconate'/de OR 'ferrous gluconate')) OR 'ferrous sulphate' OR 'ferrous lactate' OR (('ferrous fumarate'/exp OR 'ferrous fumarate') OR ('ferrous fumarate'/de OR 'ferrous fumarate')) OR 'iron amino acid chelate' OR (('ferrous sulfate'/exp OR 'ferrous sulfate') OR ('ferrous sulfate'/de OR 'ferrous sulfate')) OR (('iron dextran'/exp OR 'iron dextran') OR ('iron dextran'/de OR 'iron dextran')) OR (('iron sorbitol'/exp OR 'iron sorbitol') OR ('iron sorbitol'/de OR 'iron sorbitol')) OR (('iron sucrose'/exp OR 'iron sucrose') OR ('iron sucrose'/de OR 'iron sucrose')) OR (('sodium ferric gluconate'/exp OR 'sodium ferric gluconate') OR ('sodium ferric gluconate'/de OR 'sodium ferric gluconate')) OR 'iron-polysaccharide' OR 'iron polysaccharide' OR (('ferrous compounds'/exp OR 'ferrous compounds') OR ('ferrous compounds'/de OR 'ferrous compounds')) OR (('iron compounds'/exp OR 'iron compounds') OR ('iron compounds'/de OR 'iron compounds')) OR (('iron-dextran complex'/exp OR 'iron-dextran complex') OR ('iron-dextran complex'/de OR 'iron-dextran complex')) OR (('ferric compounds'/exp OR 'ferric compounds') OR ('ferric compounds'/de OR 'ferric compounds'))19021

#3('human immunodeficiency virus infection'/exp OR 'human immunodeficiency virus infection') OR (('human immunodeficiency virus'/exp OR 'human immunodeficiency virus')) OR (('b cell lymphoma'/de OR 'b cell lymphoma')) OR (hiv:ti OR hiv:ab) OR ('hiv-1':ti OR 'hiv-1':ab) OR ('hiv-2':ti OR 'hiv-2':ab) OR ('human immunodeficiency virus':ti OR 'human immunodeficiency virus':ab) OR ('human immunedeficiency virus':ti OR 'human immunedeficiency virus':ab) OR ('human immune-deficiency virus':ti OR 'human immune-deficiency virus':ab) OR ('human immuno-deficiency virus':ti OR 'human immuno-deficiency virus':ab) OR ('acquired immunodeficiency syndrome':ti OR 'acquired immunodeficiency syndrome':ab) OR ('acquired immuno-deficiency syndrome':ti OR 'acquired immuno-deficiency syndrome':ab) OR ('acquired immune-deficiency syndrome':ti OR 'acquired immune-deficiency syndrome':ab) OR ('acquired immunedeficiency syndrome':ti OR 'acquired immunedeficiency syndrome':ab)287089

#4((random*:ti OR random*:ab) OR (factorial*:ti OR factorial*:ab) OR (cross?over*:ti OR cross?over*:ab OR crossover*:ti OR crossover*:ab) OR (placebo*:ti OR placebo*:ab) OR ((doubl*:ti AND blind*:ti) OR (doubl*:ab AND blind*:ab)) OR ((singl*:ti AND blind*:ti) OR (singl*:ab AND blind*:ab)) OR (assign*:ti OR assign*:ab) OR (allocat*:ti OR allocat*:ab) OR (volunteer*:ti OR volunteer*:ab) OR (('crossover procedure'/de OR 'crossover procedure')) OR (('double-blind procedure'/de OR 'double-blind procedure')) OR (('single-blind procedure'/de OR 'single-blind procedure')) OR (('randomized controlled trial'/de OR 'randomized controlled trial')))784293

#5#1 OR #238743

#6#3 AND #4 AND #5 AND [1980-2008]/py38

 
Table 3. AIDSearch Strategy

SearchMatchesSearch strategy

#1269,827(HIV INFECTIONS) OR HIV OR HIV OR HIV-1* OR HIV-2* OR HIV1 OR HIV2 OR (HIV INFECT*) OR (HUMAN IMMUNODEFICIENCY VIRUS) OR (HUMAN IMMUNEDEFICIENCY VIRUS) OR (HUMAN IMMUNO-DEFICIENCY VIRUS) OR (HUMAN IMMUNE-DEFICIENCY VIRUS) OR ((HUMAN IMMUN*) AND (DEFICIENCY VIRUS)) OR (ACQUIRED IMMUNODEFICIENCY SYNDROME) OR (ACQUIRED IMMUNEDEFICIENCY SYNDROME) OR (ACQUIRED IMMUNO-DEFICIENCY SYNDROME) OR (ACQUIRED IMMUNE-DEFICIENCY SYNDROME) OR ((ACQUIRED IMMUN*) AND (DEFICIENCY SYNDROME)) OR (SEXUALLY TRANSMITTED DISEASES, VIRAL)

#2153,716((RANDOMIZED CONTROLLED TRIAL) OR (CONTROLLED CLINICAL TRIAL) OR (RANDOMIZED CONTROLLED TRIALS) OR (RANDOM ALLOCATION) OR (DOUBLE-BLIND METHOD) OR (SINGLE-BLIND METHOD) OR (CLINICAL TRIAL) OR (CLINICAL TRIALS) OR ("CLINICAL TRIAL") OR ((SINGL* OR DOUBL* OR TREBL* OR TRIPL* AND (MASK* OR BLIND* )) OR PLACEBOS OR PLACEBO* OR RANDOM* OR (COMPARATIVE STUDY) OR (EVALUATION STUDIES) OR (FOLLOW-UP STUDIES) OR (PROSPECTIVE STUDIES) OR CONTROL* OR PROSPECTIV* OR VOLUNTEER*)) NOT (ANIMALS NOT HUMAN )

#3109,587#1 AND #2

#4100(FERROUS SALT) OR (FERROUS GLUCONATE) OR (FERROUS SULPHATE) OR (FERROUS LACTATE) OR (FERROUS FUMARATE) OR (IRON AMINO ACID CHELATE) OR (FERROUS SULFATE) OR (IRON DEXTRAN) OR (IRON SORBITOL) OR (IRON SUCROSE) OR (SODIUM FERRIC GLUCONATE) OR (IRON-POLYSACCHARIDE) OR (IRON POLYSACCHARIDE) OR (FERROUS COMPOUNDS) OR (IRON COMPOUNDS) OR (IRON-DEXTRAN COMPLEX) OR (FERRIC COMPOUNDS)

#5148(IRON SUPPLEMENTATION) OR (IRON DEFICIENCY) OR (IRON AND (DIETARY SUPPLEMENTS)) OR (SUPPLEMENTARY IRON) OR (IRON DEFICIENCY ANEMIA) OR (IRON-DEFICIENCY ANEMIA) OR (IRON DEFICIENCY ANEMIAS) OR (IRON-DEFICIENCY ANEMIAS) OR (IRON DEFICIENCY ANAEMIA) OR (IRON-DEFICIENCY ANAEMIA) OR (IRON DEFICIENCY ANAEMIAS) OR (IRON-DEFICIENCY ANAEMIAS) OR (ANEMIA, IRON-DEFICIENCY)

#6243#4 OR #5

#760#3 AND #6

 
Table 4. GATEWAY strategy

SearchSearch termsResults

#1Search: ((HIV INFECTIONS) OR HIV OR HIV OR HIV-1* OR HIV-2* OR HIV1 OR HIV2 OR (HIV INFECT*) OR (HUMAN IMMUNODEFICIENCY VIRUS) OR (HUMAN IMMUNEDEFICIENCY VIRUS) OR (HUMAN IMMUNO-DEFICIENCY VIRUS) OR (HUMAN IMMUNE-DEFICIENCY VIRUS) OR ((HUMAN IMMUN*) AND (DEFICIENCY VIRUS)) OR (ACQUIRED IMMUNODEFICIENCY SYNDROME)) OR ((ACQUIRED IMMUNEDEFICIENCY SYNDROME) OR (ACQUIRED IMMUNO-DEFICIENCY SYNDROME) OR (ACQUIRED IMMUNE-DEFICIENCY SYNDROME) OR ((ACQUIRED IMMUN*) AND (DEFICIENCY SYNDROME)) OR (SEXUALLY TRANSMITTED DISEASES, VIRAL))330943

#2Search: ((RANDOMIZED CONTROLLED TRIAL) OR (CONTROLLED CLINICAL TRIAL) OR (RANDOMIZED CONTROLLED TRIALS) OR (RANDOM ALLOCATION) OR (DOUBLE-BLIND METHOD) OR (SINGLE-BLIND METHOD) OR (CLINICAL TRIAL) OR (CLINICAL TRIALS) OR (CLINICAL TRIAL) OR ((SINGL* OR DOUBL* OR TREBL* OR TRIPL*) AND (MASK* OR BLIND* ))) OR (PLACEBOS OR PLACEBO* OR RANDOM* OR (COMPARATIVE STUDY) OR (EVALUATION STUDIES) OR (FOLLOW-UP STUDIES) OR (PROSPECTIVE STUDIES) OR CONTROL* OR PROSPECTIV* OR VOLUNTEER*)99536

#3Search: ((IRON SUPPLEMENTATION) OR (IRON DEFICIENCY) OR (IRON AND (DIETARY SUPPLEMENTS[MH])) OR (SUPPLEMENTARY IRON) OR (IRON DEFICIENCY ANEMIA) OR (IRON-DEFICIENCY ANEMIA) OR (IRON DEFICIENCY ANEMIAS) OR (IRON-DEFICIENCY ANEMIAS) OR (IRON DEFICIENCY ANAEMIA) OR (IRON-DEFICIENCY ANAEMIA) OR (IRON DEFICIENCY ANAEMIAS) OR (IRON-DEFICIENCY ANAEMIAS) OR ANEMIA, IRON-DEFICIENCY[MH]) OR ((FERROUS SALT) OR (FERROUS GLUCONATE) OR (FERROUS SULPHATE) OR (FERROUS LACTATE) OR (FERROUS FUMARATE) OR (IRON AMINO ACID CHELATE) OR (FERROUS SULFATE) OR (IRON DEXTRAN) OR (IRON SORBITOL) OR (IRON SUCROSE) OR (SODIUM FERRIC GLUCONATE) OR (IRON-POLYSACCHARIDE) OR (IRON POLYSACCHARIDE) OR FERROUS COMPOUNDS[MH] OR IRON COMPOUNDS[MH] OR (IRON-DEXTRAN COMPLEX) OR FERRIC COMPOUNDS[MH])55459

#4Search: (((HIV INFECTIONS) OR HIV OR HIV OR HIV-1* OR HIV-2* OR HIV1 OR HIV2 OR (HIV INFECT*) OR (HUMAN IMMUNODEFICIENCY VIRUS) OR (HUMAN IMMUNEDEFICIENCY VIRUS) OR (HUMAN IMMUNO-DEFICIENCY VIRUS) OR (HUMAN IMMUNE-DEFICIENCY VIRUS) OR ((HUMAN IMMUN*) AND (DEFICIENCY VIRUS)) OR (ACQUIRED IMMUNODEFICIENCY SYNDROME)) OR ((ACQUIRED IMMUNEDEFICIENCY SYNDROME) OR (ACQUIRED IMMUNO-DEFICIENCY SYNDROME) OR (ACQUIRED IMMUNE-DEFICIENCY SYNDROME) OR ((ACQUIRED IMMUN*) AND (DEFICIENCY SYNDROME)) OR (SEXUALLY TRANSMITTED DISEASES, VIRAL))) AND (((RANDOMIZED CONTROLLED TRIAL) OR (CONTROLLED CLINICAL TRIAL) OR (RANDOMIZED CONTROLLED TRIALS) OR (RANDOM ALLOCATION) OR (DOUBLE-BLIND METHOD) OR (SINGLE-BLIND METHOD) OR (CLINICAL TRIAL) OR (CLINICAL TRIALS) OR (CLINICAL TRIAL) OR ((SINGL* OR DOUBL* OR TREBL* OR TRIPL*) AND (MASK* OR BLIND* ))) OR (PLACEBOS OR PLACEBO* OR RANDOM* OR (COMPARATIVE STUDY) OR (EVALUATION STUDIES) OR (FOLLOW-UP STUDIES) OR (PROSPECTIVE STUDIES) OR CONTROL* OR PROSPECTIV* OR VOLUNTEER*)) AND (((IRON SUPPLEMENTATION) OR (IRON DEFICIENCY) OR (IRON AND (DIETARY SUPPLEMENTS[MH])) OR (SUPPLEMENTARY IRON) OR (IRON DEFICIENCY ANEMIA) OR (IRON-DEFICIENCY ANEMIA) OR (IRON DEFICIENCY ANEMIAS) OR (IRON-DEFICIENCY ANEMIAS) OR (IRON DEFICIENCY ANAEMIA) OR (IRON-DEFICIENCY ANAEMIA) OR (IRON DEFICIENCY ANAEMIAS) OR (IRON-DEFICIENCY ANAEMIAS) OR ANEMIA, IRON-DEFICIENCY[MH]) OR ((FERROUS SALT) OR (FERROUS GLUCONATE) OR (FERROUS SULPHATE) OR (FERROUS LACTATE) OR (FERROUS FUMARATE) OR (IRON AMINO ACID CHELATE) OR (FERROUS SULFATE) OR (IRON DEXTRAN) OR (IRON SORBITOL) OR (IRON SUCROSE) OR (SODIUM FERRIC GLUCONATE) OR (IRON-POLYSACCHARIDE) OR (IRON POLYSACCHARIDE) OR FERROUS COMPOUNDS[MH] OR IRON COMPOUNDS[MH] OR (IRON-DEXTRAN COMPLEX) OR FERRIC COMPOUNDS[MH])) Limit: 1980:200771

13 meeting abstracts found

 
Table 5. Cochrane Clinical Trials Register

SearchSearch termsResults

#1("HIV INFECTIONS" in All Text or HIV in All Text or HIV in All Text or "HIV-1*" in All Text or "HIV-2*" in All Text or HIV1 in All Text or HIV2 in All Text or "HIV INFECT*" in All Text or "HUMAN IMMUNODEFICIENCY VIRUS" in All Text or "HUMAN IMMUNEDEFICIENCY VIRUS" in All Text or "HUMAN IMMUNO-DEFICIENCY VIRUS" in All Text or "HUMAN IMMUNE-DEFICIENCY VIRUS" in All Text or ("HUMAN IMMUN*" in All Text and "DEFICIENCY VIRUS" in All Text) or "ACQUIRED IMMUNODEFICIENCY SYNDROME" in All Text or "ACQUIRED IMMUNEDEFICIENCY SYNDROME" in All Text or "ACQUIRED IMMUNO-DEFICIENCY SYNDROME" in All Text or "ACQUIRED IMMUNE-DEFICIENCY SYNDROME" in All Text or ("ACQUIRED IMMUN*" in All Text and "DEFICIENCY SYNDROME" in All Text) or "SEXUALLY TRANSMITTED DISEASES, VIRAL" in All Text)7230

#2("IRON SUPPLEMENTATION" in All Text or "IRON DEFICIENCY" in All Text or "IRON AND (DIETARY SUPPLEMENTS)" in All Text or "SUPPLEMENTARY IRON" in All Text or "IRON DEFICIENCY ANEMIA" in All Text or "IRON-DEFICIENCY ANEMIA" in All Text or "IRON DEFICIENCY ANEMIAS" in All Text or "IRON-DEFICIENCY ANEMIAS" in All Text or "IRON DEFICIENCY ANAEMIA" in All Text or "IRON-DEFICIENCY ANAEMIA" in All Text or "IRON DEFICIENCY ANAEMIAS" in All Text or "IRON-DEFICIENCY ANAEMIAS" in All Text or "ANEMIA, IRON-DEFICIENCY" in All Text)1155

#3("FERROUS SALT" in All Text or "FERROUS SALT" in All Text or "FERROUS GLUCONATE" in All Text or "FERROUS SULPHATE" in All Text or "FERROUS LACTATE" in All Text or "FERROUS FUMARATE" in All Text or "IRON AMINO ACID CHELATE" in All Text or "FERROUS SULFATE" in All Text or "IRON DEXTRAN" in All Text or "IRON SORBITOL" in All Text or "IRON SUCROSE" in All Text or "SODIUM FERRIC GLUCONATE" in All Text or "IRON-POLYSACCHARIDE" in All Text or "IRON POLYSACCHARIDE" in All Text or "FERROUS COMPOUNDS" in All Text or "IRON COMPOUNDS" in All Text or "IRON-DEXTRAN COMPLEX" in All Text or "FERRIC COMPOUNDS" in All Text)730

#4(#2 or #3)1497

#5(#1 and #4) from 1980 to 200730

 
Table 6. World Health Organization: Clinical Staging of HIV for Infants and Children

Clinical stage 1Clinical stage 2Clinical stage 3Clinical stage 4

AsymptomaticUnexplained persistent hepatosplenomegalyUnexplained malnutrition not adequately responding to standard therapyUnexplained severe wasting, stunting or severe malnutrition not responding to standard therapy

Persistent generalized lymphadenopathyPapular pruritic eruptionsUnexplained persisitent diarrhoea (14 days or more)Pneumocystis pneumonia

Extensive wart virus infectionUnexplained persistent fever (above 37.5 Celsius, intermittent or constant, for longer than 1 month)Recurrent severe bacterial infections (e.g. empyema, pyomyositis, bone or joint infection, meningitis) excluding pneumonia

Extensive molluscum contagiosumPersistent oral candidiasis (after first 6 weeks of life)Chronic herpes simplex infection; orolabial or cutaneous of more than one month's duration, or visceral at any site

Recurrent oral ulcerationsOral hairy leukoplakiaExtrapulmonary tuberculosis

Unexplained persistent parotid enlargementAcute necrotizing ulcerative gingivitis/periodontitisKaposi sarcoma

Lineal gingival erythemaLymph node tuberculosisOesophageal candidiasis (or candida of trachea, bronchi, or lungs)

Herpes zosterPulmonary tuberculosisCentral nervous system toxoplasmosis (after neonatal period)

Recurrent or chronic upper respiratory tract infections (otitis media, otorrhoea, sinusitis, tonsillitis)Severe recurrent bacterial pneumoniaHIV encephalopathy

Fungal nail infectionsSymptomatic lymphoid intersitial pneumonitisCytomegalovirus (CMV) infection; retinitis or CMV infection affecting another organ, with onset at age over 1 month

Chronic HIV-associated lung disease including bronchiectasisExtrapulmonary cryptococcosis (including meningitis)

Unexplained anaemia (<8.0 g/dL), neutropenia (<500/mm3), or chronic thrombocytopenia (<50 000/mm3)Disseminated endemic mycosis (extrapulmonary histoplasmosis, coccidiomycosis)

Chronic cryptosporidiosis (with diarrhoea)

Chronic isosporiasis

Disseminated non-tuberculous mycobacterial infection

Cerebral or B cell non-Hodgkin lymphoma

Progressive multifocal leukoencephalopathy

HIV-associated cardiomyopathy or nephropathy