Children with HIV and AIDS

HIV and AIDS are not only causing untold human suffering, they are also reversing decades of development progress in some countries. The spread of the disease and its evolution varies from region to region. But what is common is that HIV and AIDS are increasingly a disease of the young and most vulnerable, particularly girls. Of the 2.1 million children living with HIV in 2007, 420,000 were children, mainly through mother-to-child transmission.

Why should I be aware of this?

• It was estimated that in 2007, 2.1 million children under 15 years of age were living with HIV virus and 290,000 children died of AIDS and 420,000 children were newly infected. Over 15 million children under 18 have lost one or both parents to AIDS, and millions more have been made vulnerable.
• Children affected by HIV and AIDS experience poverty, homelessness, school drop-out, discrimination, loss of life opportunity, and early death.
• In majority of cases of children HIV virus is transmitted from the mother during pregnancy or birth, or through breast milk.
• HIV has been found to thrive mostly among tragic conditions of poverty, abuse, violence, prejudice and ignorance.

All about children with HIV and AIDS

While recently there have been a number of discoveries and advances in understanding and controlling the virus that causes AIDS, this progress has had limited impact on the majority of HIV infected people and populations living in developing countries.

Many people don't show any particular symptoms, such as a brief flu-like illness two to six weeks after infection, accompanied by fever, headache, sore throat and swollen lymph glands and children are often infected while in the womb.

Illness patterns and symptoms

Generally there are two patterns of illness in HIV-infected children.

• About 20 per cent develop serious disease in the first year of life, and generally die by the age of four
• In the remaining 80 per cent, there is a slow progression of the disease.

Children with HIV do not have normal growth and often fail to gain weight. They may develop problems with walking, or show delayed mental development. They are vulnerable to infections and can face severe normal childhood infections. Swollen lymph glands may be the first sign of AIDS. Other symptoms may include:

• Weight loss
• Diarrhoea
• Fever
• Cough
• Weakness
• Shortness of breath
• Headaches
• Night sweats
• Visual problems
• Dementia
• A variety of cancers

If untreated, these problems and related complications may be rapidly fatal.

Diagnosis and treatment

• Diagnosis is done through a blood test to detect antibodies to the virus. It can take up to 12 weeks after infection for these antibodies to be made, so an HIV test may, initially, be negative.
• All children born to infected mothers receive some of their mother's antibodies to HIV across the placenta. These may persist for up to 18 months, making antibody tests inaccurate.
• Newer blood tests can detect tiny quantities of the virus in the infant's blood, giving an accurate diagnosis in about 95 per cent of HIV-infected infants by three months of age.
• AIDS is defined as a positive test for HIV combined with either an opportunistic infection (an infection that only occurs when your immune system isn't working properly, such as pneumocystis carinii pneumonia) or an abnormally low level of a type of white blood cell called a CD4 lymphocyte.
• A count of 200 or less is abnormal - normal levels range from 600 to 1,000.
• Children may also have more severe forms of common childhood bacterial infections, such as conjunctivitis (pink eye), ear infections and tonsillitis.
• Drug treatments, using a combination of several drugs known as highly active antiretroviral therapy, have greatly improved the outlook for people AIDS. But drugs can't cure the infection, and side-effects and drug resistance are still a major problem.
• Other therapies can greatly improve quality of life.

Poverty factor

A major factor which had spread HIV/AIDS is poverty. The virus does not demonstrate immediate harm, but everyday struggle for survival for these people overshadow the need for attention and concern. Due to poverty these people are not only deprived of proper medical facilities, but schools and media also limits their access to information and education on HIV/AIDS.

When HIV/AIDS appears in an impoverished household there are limited means for response, the mortality rate is high, the impact is severe and the pressures and pain of poverty increase. As increasing numbers of infected young adults are unable to contribute to their communities through their work as parents, teachers, laborers, drivers, farmers, etc., entire economic and social structures of communities suffer and demands for services increase with fewer able people to provide them.

CopperBytes

• In many countries, the HIV epidemic is still considered ‘low’ or ‘concentrated,’ confined mainly to individuals who engage in high risk behaviors, such as men who have sex with men, people who inject drugs, prisoners, and sex workers.
• In sub-Saharan Africa, parts of Asia, Central America and the Caribbean, HIV has become a ‘generalized’ epidemic. An epidemic is considered ‘generalized’ when more than one per cent of the population is HIV-positive.
• Stigma and discrimination remain the most potent barrier to testing, treatment and prevention. This explains in part why, in some countries, up to 90 per cent of people who are HIV-positive don’t know their status.
• Women comprise about half of all people living with HIV worldwide.
• In unprotected heterosexual intercourse women are twice as likely as men to acquire HIV from an infected partner.
• Children, and in particular girls, are being pulled out of school to care for their AIDS-affected families.

90 degrees

It is often very difficult to diagnose HIV infection in very young children. Most often they appear normal and may show no telltale signs allowing for a definitive diagnosis of HIV infection. Moreover, all children born to infected mothers have antibodies to HIV, made by the mother's immune system, that cross the placenta to the baby's bloodstream before birth and persist for up to 18 months. Because these maternal antibodies reflect the mother's but not the infant's infection status, the test for HIV infection is not useful in newborns or young infants.

In recent years, investigators have demonstrated the utility of highly accurate blood tests in diagnosing HIV infection in children 6 months of age and younger. One laboratory technique, called polymerase chain reaction (PCR), can detect minute quantities of the virus in an infant's blood. Another procedure allows physicians to culture a sample of an infant's blood and test it for the presence of HIV.

References:

• The big picture
• Children and HIV and AIDS