An HIV infection is a range of conditions caused by infection with the human immunodeficiency virus. As the infection progresses, it interferes with the immune system. HIV attacks and destroys cells of the immune system that fight infection, called CD4 cells. When these CD4 cells get destroyed, the body finds it difficult to fight infections and some cancers. In the absence of treatment, HIV will destroy the immune system and advance to its late stage called AIDS.
The number of children infected with HIV has increased dramatically especially in developing countries as a result of increased numbers of HIV infected women of childbearing age.
According to the World Health Organization (WHO), by the end of 2013, an estimated 3.2 million children around the world were living with HIV/AIDS. Most cases of childhood HIV and AIDS are in sub-Saharan Africa, the southern part.
Research has shown that between 25% to 30% of children infected with HIV die before their first birthday. More than half of them develop symptoms early in life and in the absence of effective diagnosis and treatment, they die by the time they are 2 years old.
CAUSE OF HIV INFECTION IN CHILDREN
HIV infection is caused by the human immunodeficiency virus. There are two strains; HIV-1 and HIV-2. HIV-1 is common in America, Asia, Europe and Africa. HIV-2 causes epidemics in Africa although it can be found in Europe. It is known that HIV-2 progresses more slowly and is less transmissible than HIV-1.
How does a child get infected with HIV?
Below are a few ways a child could get infected with HIV:
• HIV could be transmitted vertically; before birth (in utero), during delivery or after birth from breastfeeding.
• A child can be infected through sexual intercourse, e.g. rape, child marriages, etc
• Contaminated blood transfusion is another way a child would get infection.
• A child can also be infected by injections with unsterilized needles.
SYMPTOMS OF HIV IN CHILDREN
Not all children with HIV infection will have symptoms and those that have symptoms would not all have similar ones. Below are some of the symptoms a child may experience:
• Failure to thrive which means the child fails to gain weight.
• Failure to reach developmental milestones.
• Brain or nervous system problems which include frequent seizures, poor performance in school, etc.
• Skin rashes
• Children with HIV infection also get opportunistic infections. These are infections that would rarely harm a healthy individual but are a life threatening condition for people with weak immune systems.
DIAGNOSIS OF HIV IN CHILDREN
Prompt diagnosis of HIV infection is important so treatment can be started as soon as possible.
Diagnostic tests to detect the presence of antibodies to HIV in the blood are usually inexpensive and readily available, however, for a baby born to an HIV infected woman, the mother’s antibodies are in the baby’s blood. It takes up to about a year or 18 months for the antibodies to be cleared while the baby’s immune system develops its own. So using these tests for a baby younger than 18 months is ineffective and diagnosis will require more sophisticated tests which will detect the virus itself.
Below are a few lab investigations that would be done:
• Blood test for HIV antibodies
• CD4 count
• Hepatitis B surface antigen
• Full Blood Count (FBC)
• Liver Function Test (LFT)
TREATMENT OF HIV IN CHILDREN
After thorough assessments and investigations, HIV infected children would be put on an anti- retroviral therapy which is a combination of medications. However, there are no suitable formulations for children as the ART are produced in tablet form. Syrup forms have been developed but either have foul taste, must be taken in large volumes or having a short shelf life and so make it difficult for a child to take. Work is being done to improve the syrups for babies and younger children.
PREVENTION OF HIV IN CHILDREN
Below are a few preventive methods of HIV infection in children. There are preventive mother to child transmission interventions being done worldwide to reduce the transmission of HIV to children. A few include:
- A scheduled Cesarean Section.
- Babies will receive anti-retroviral medications four to six weeks after birth.
- Baby formula is substituted for breastmilk.
- Mothers should be receiving anti-retroviral therapy during their pregnancy.
- Blood to be donated should be screened thoroughly.
- Only sterile needles should be used for injections.
- Young children who are sexually active should be educated on safe sex.
• Standard Treatment Guidelines, Sixth Edition