456 new cases of human immunodeficiency virus (HIV) infections were reported in 2014. The total number of Singaporeans with HIV is now 6,685 as the end of 2014.
Would the infection be passed on to the infant? Is there a way to prevent mother-to-child transmission? How can one deal with a child who is infected with HIV?
Definition
HIV is one of the deadliest diseases worldwide which causes AIDS (acquired immune deficiency syndrome). It attacks the immune system by damaging the cells, rendering the body unable to fight off infections and certain types of cancer.
Signs and Symptoms of HIV
Babies and infants infected may not show signs and symptoms of HIV immediately; they initially appear healthy. So if a mother suspects she has HIV, it’s best to have herself and the baby tested.
However, in about two to three months, the following signs and symptoms of HIV will manifest:
- Low growth rate compared to other babies his age
- Not reaching standard developmental milestones of babies his age
- Has an enlarged liver or spleen
- Periodic illnesses such as colds, upset stomach, diarrhea, ear infections
- Problems with brain or nervous system. Common symptoms are walking difficulties, occurrence of seizures and poor academic performance
Transmission
The most common ways that HIV is transmitted to a child are: perinatal or during pregnancy, childbirth or breastfeeding.
Other types of transmissions (which may or may not be applicable to children) are:
- Blood
- Drug use. Sharing needles used to introduce drugs to the body can occur in children in as young as 10
- Sexual interaction. Unprotected sex with someone infected with HIV
- Other bodily fluids: semen, vaginal and rectal
Risk Factors
Having a mother who is infected with HIV and does not receive proper prenatal treatment for HIV. This is why mothers should be aware of signs and symptoms of HIV and be able to determine if they have it. Those who suspect they have it should immediately have themselves tested.
Complications
If left untreated, HIV in children may cause:
- Common infections of children: Epstein-Barr virus (EBV) infection
- Tuberculosis which is more common in developing countries
The major complication of HIV is that it can develop into AIDS.
Advanced HIV leads to opportunistic infections, which occasionally affect healthy people but are fatal for those who have weakened or compromised immune systems.
- Pneumocystis pneumonia
- Serious infection due to cytomegalovirus (CMV)
- Lymphocytic interstitial pneumonitis (LIP) or lung scarring
- Severe diaper rash or oral thrush because of Candida, a yeast infection
- Enlarged lymph nodes
Tests and Diagnosis
- HIV test - determines antibodies to HIV either through blood or another type of sample
- HIV viral load - This is done after one tests positive for HIV. The purpose is determining whether HIV is increasing or not--an increase means the condition is worsening
- CD4 cell count - Gives doctors idea on how the immune system is doing in those affected with HIV
- Pregnancy and HIV testing
Treatments and Drugs
Untreated HIV will develop to AIDS; therefore, receiving treatment is crucial.
Treatments for children and adults are the same: multiple medications that prevent the virus from resisting drugs; prevent or delay the onset of AIDS; prolonging the state of being free from signs and symptoms of HIV; drugs that inhibit spread of HIV from mother to child.
The drugs that treat HIV are expensive yet effective. They are usually administered, as mentioned earlier, in a combination or a cocktail of drugs. This is referred to as HAART (highly active anti retroviral therapy).
Drugs that prevent opportunistic illnesses may also be given.
Note that medications must be religiously taken as prescribed by the doctor lest the virus become resistant to the drugs, rendering the virus difficult or, worse, impossible to treat.
This makes treatment more challenging when it comes to children since it can be difficult to get them to take scheduled medications.
However, there are limitations to the treatment drugs: some are not available/administered in liquid form and others have side effects.
Note that despite the absence of signs and symptoms of HIV in children infected with the virus, doctors will recommend for them to start on medication to increase their survival rate.
Support at Home
Emotional
If a child has HIV, it is best to explain it to him in a manner that he understands. Also, as a parent, read up on HIV and AIDS to arm yourself with knowledge that can make your child more comfortable now and in his adult life, improve his quality of life and help him towards leading a normal life.
One of the best things to do is provide emotional support by always being available to answer questions the child has, or be there during times of need. Teach the child different ways to deal with stress as well by using breathing techniques or getting into hobbies.
Lastly, have your child understand everything about his condition (from signs and symptoms of HIV to complications) so that he can make healthier choices in life as well.
Consider having a psychiatrist or psychologist speak with a child who is not taking his condition, and its life-long attachment to him, well. He may also be dealing with the stigma that comes with being infected with HIV.
Here's a list of HIV counselling centers in the Singapore:
- Health Promotion Board Tel: 1800-223 1313
- Action for Aids (Singapore) Tel:(65) 6254 0212
- Communicable Disease Centre Tel: (65) 6256 6011
- DSC Clinic Tel: (65) 6293 9648 (Appointments)
(65) 1800-252 1324 (Confidential Counselling)
Health
A child infected with HIV must be monitored to regularly receive his treatments and to ensure that any infections that are potentially life-threatening are caught early on.
If a child is taken to the emergency room, the accompanying adult must alert the staff immediately of the HIV infection. That way, the staff will be on the lookout for signs of opportunistic infections.
Prevention
For the parent: Prevent or decrease the mother-to-child infection by getting diagnosed early on and receiving treatment. A mother who receives proper care reduces the chances of her passing HIV to her baby.
Antiviral treatments are given to mothers before childbirth and at the time of childbirth.
After birth, an infected mother will be discouraged from breastfeeding since doing so risks the chance of passing on HIV to her baby.
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