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  • Title: [Children and HIV. Diagnosis of HIV].
    Author: Tindyebwa D, Marum L.
    Journal: Action Contre SIDA; 1995 Oct; (26):4-5. PubMed ID: 12291925.
    Abstract:
    About 40% of newborns infected with HIV do not live to their first birthday. More than half of those die around 2 months old. The remaining HIV-infected newborns survive the opportunistic infections appearing at a young age, then their health improves, and they survive to around age 6. HIV can be diagnosed after a laboratory test and/or based on clinical signs and symptoms. The latter is less precise than the HIV test but the HIV test is either very expensive or the laboratory is not equipped to test for HIV. For infants younger than 18 months, a positive HIV test is not reliable. All infants of HIV- positive mothers are born with maternal HIV antibodies that remain active for 12-18 months. The main advantages of diagnosing HIV in an infant are that opportunistic infections can be identified and treated quickly and that health workers can detect potentially fatal childhood infections very early. Good care of the HIV-infected child includes good nutrition, rapid treatment of childhood infections, appropriate vaccination, early diagnosis and treatment of tuberculosis among family members, oral rehydration therapy, growth monitoring, treating the child like a normal child (e.g., playing), and providing comfort. It is important to explain to the family that, with good care, the HIV-infected child can survive a long time. The mother and other family members need counseling and support. Older HIV-infected children would need special treatment. HIV-positive infants tend to be of low birth weight. Symptoms (e.g., bacterial infections and lymphadenopathy) begin to appear around 2-3 months. Around 6-15 months, HIV-related signs include growth problems (first growth stoppage then weight loss), chronic diarrhea, and tuberculosis (difficult to diagnose, however). Symptoms for children older than 15 months include the aforementioned symptoms plus itchy eruptions, enlarged lymph nodes, chronic cough, and development difficulties (e.g., learning to walk or speak later than usual).
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