781 Psychiatric Hospitalizations Among HIV-infected Children and Youth S. Nachman*1, D. M. Gaughan2, K. Malee3, J. M. Oleske4, M. D. Hughes2 1State Univ of New York, Stony Brook; 2Harvard Sch of Public Hlth, Boston, MA; 3Chicago Children's Mem Hosp, IL; and 4Univ of Med and Dentistry of New Jersey, NJ Med Sch, Newark
Background: Psychiatric hospitalizations among the pediatric HIV-infected population have not been reported in the published literature.
Methods: PACTG 219C is a prospective cohort study to examine long-term outcomes in HIV-infected children and in HIV- children born to HIV-infected women. Infected children who have enrolled in 219C are examined quarterly with collection of clinical and laboratory data. Hospitalizations and diagnoses were reviewed for participants from September 2000 (when enrollment to PACTG 219C started) to October 2002.
Results: Among 1,807 HIV-infected participants under 15 yrs of age at last visit date, 21 children were hospitalized for psychiatric manifestations, 7 prior to enrollment in PACTG 219C. Among the prevalent cases, 3 children were admitted for depression, 3 for behavioral disorders and 1 for psychosis. Fourteen (14) children were hospitalized during 2,046 person years (PY) of follow-up representing an incidence rate of 6.84 per 1000 PY (95% CI=3.74, 11.5) which was significantly higher the general pediatric incidence rate of 1.70 per 1000 PY (95% CI= 1.69, 1.71) as reported in the 2000 National Hospital Discharge Survey giving a relative risk of 4.02 (95% CI=2.20, 6.74). The majority of incident cases were admitted for depression (n = 7) or behavioral disorders (n = 5). Eleven (11; 52%) had multiple psychiatric hospitalizations. The median age at first psychiatric hospitalization was 12 yrs (range 5-14 yrs); all had been perinatally infected. Race/ethnicity or gender were not associated with admission. No psychiatric hospitalizations were observed for the 976 HIV-negative members of the cohort.
Conclusions: Children with HIV/AIDS are at an increased risk for psychiatric hospitalizations during childhood and early adolescence compared to the general pediatric population. Screening for warning signs of psychiatric illness should be provided within the context of comprehensive primary care. As these children live longer with the disease in a chronic state, the incidence of psychiatric hospitalizations may increase.
