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TEXTS OF THE CONGRESS

THE PEDIATRIC AIDS IN ROMANIA
Maya EL HACHEM, G. CASTELLI GATTINARA
Bambino Gesù Hospital of Rome , Italy

The HIV/AIDS infection is today an epidemic afflicting adults and children in almost every country in the world. The highest percentage of infected children in Europe is reported by Romania and Italy.
In the frame of an humanitarian project conduced in Romania, since 1996 by the Bambino Gesù Hospital and italian and romanian NGO, we have studied the clinical mucocutaneous manifestations and their medical and surgical treatment on a group of 1.000 romanian HIV positive children.

The finalities of our project are:
• To be coherent with the identity of our catholic hospital;
• To treat the dermatological manifestations;
• to prevent severe diseases;
• to prevent spreading of the infections between the children and the medical staff;
• to look to the hygienic conditions of the children;
• to train the romanian staff involved in the treatment of HIV infected children;
• to share with romanian collegues our cultural and scientific experiences.
• To give the economic and practical possibility to the romanian collegue to treat themselves the children through a Mobile Unit.

The analysis of the frequency of dermatological disorders showed that in the romanian HIV infected children more than 90% showed at least one cutaneous lesion but many had simultaneously more than one disease.
The cutaneous manifestations observed can be divided into two major groups. The most important are infections or infestations that tend to be more severe and recurrent than in the healthy children. The second group is composed of inflammatory disorders, nutritional deficiencies and cutaneous neoplasm (Kaposi sarcoma).
Cutaneous pathologies associated with HIV/AIDS are often present in atypical clinical forms which require histologic tests for an exact diagnosis and which often are resistant to conventional therapies.

The frequencie's increase of the cutaneous pathologies in HIV infected children is due to:
• the deterioration of the immune system: patients with the lower levels of CD4 lymphocytes are more susceptible to cutaneous disorders, in particular the infectious types;
• the fact that they are often abandoned children living in orphenages;
• low hygienic conditions;
• the promiscuity;
• the underevaluation of dermatologic problems.