What are HIV and AIDS?
HIV stands for human immunodeficiency virus. HIV is the virus that
causes AIDS (acquired immunodeficiency syndrome), a
life-threatening disease.
HIV attacks the body's immune system. It destroys
infection-fighting cells. When these cells are destroyed, the
immune system can no longer defend the body against infections and
cancers.
HIV infection becomes AIDS when you lose your ability to fight off
serious infections or tumors. Various infections called
opportunistic infections develop. They are called opportunistic
because they take advantage of the weakened immune system. These
infections would not normally cause severe or fatal health
problems. However, when you have AIDS, the infections and tumors
are serious and can be fatal.
Women who are pregnant and infected with HIV may infect their
babies with the virus before or during birth. The baby can also
get the virus from breast milk. Babies who are infected may become
very sick and die.
Women should be tested for HIV at the first prenatal visit.
Treatment can help prevent spread of the infection to the baby.
What causes HIV?
HIV is transmitted through direct contact with the blood or body
fluid of someone who is infected with the virus. HIV can be passed
to an unborn baby through the placenta, by exposure to blood and
body fluids during labor and at delivery, or through
breast-feeding.
Among teens, the virus is most commonly spread through:
- unprotected sexual activity
- shared needles
- contact with infected blood or semen
- transfusion with infected blood (now rare in the US because of
blood bank screening).
HIV is not spread through:
- casual contact, such as hugs or handshakes
- dishes or drinking glasses
- sneezes or coughs
- mosquitoes or other insects
- towels
- toilet seats
- doorknobs
- typical baby secretions (urine, drool, spit up, vomit, feces).
What are the symptoms?
A baby born with HIV often has no signs of HIV infection at birth.
When babies are 2 to 3 months old, they may start having problems
such as:
- poor weight gain
- yeast infections that can cause constant diaper rash and
infections in the mouth and throat that make eating difficult
- enlarged lymph nodes
- swollen abdomens
- neurological problems (seizures, slower to walk and talk than
other children their age)
- many bacterial infections, such as pneumonia.
A child with HIV tends to get more infections, and get sicker than
other children from common childhood infections such as the flu.
Teens who get HIV may not have symptoms at the time of infection.
It may take years for symptoms to show. During this time, they can
pass on the virus without even knowing they have it. Symptoms of
AIDS may include:
- fever that lasts from a few days to longer than a month
- loss of appetite and rapid weight loss
- intense fatigue
- swollen lymph nodes
- diarrhea, especially if it lasts longer than a month
- repeated, severe yeast infections in the mouth or vagina
despite treatment
- night sweats
- pneumonia.
How is it diagnosed?
Every pregnant woman should be tested for HIV. If you are pregnant
and have tested positively for HIV, your healthcare provider will
probably prescribe HIV-fighting drugs to help prevent spread of
the virus to the baby.
If a woman is HIV-infected and already has children, all of her
children should be tested for HIV.
The baby will be tested for HIV antibodies after birth. However,
because some of the mother's antibodies to HIV may be passed on to
the baby, the test results are not always completely accurate.
Babies may be HIV-antibody positive for up to 18 months after
birth, even if they are not actually infected. Infants start to
make their own HIV antibodies after 18 months of age.
The most accurate way to check for HIV in babies is to check for
the virus itself (not antibodies). This can be done with an HIV
viral culture and a blood test called an HIV DNA PCR.
Older children and teens are tested for HIV infection by a blood
test known as an ELISA test. If this test is positive, another
more specific blood test, usually the Western blot test, is done
to confirm the results.
How is it treated?
Having a cesarean section (C-section) instead of a vaginal
delivery reduces the risk of infecting the baby. Taking antiviral
medicine during pregnancy and having a C-section greatly reduces
the mother's risk of passing on the infection.
Babies born to HIV-infected mothers may be treated with antiviral
drugs for at least the first 6 weeks of life to help prevent
infection. Mothers with HIV should not breast-feed their babies.
Giving formula instead of breast milk helps prevent spread of the
virus to the baby.
Anti-HIV drugs are used to treat HIV in babies and children. These
include antiviral medicines, such as zidovudine (ZDV or AZT),
didanosine (ddI), and lamivudine (3TC), and protease inhibitors,
such as indinavir (Crixivan), lopinavir/ritonavir (Kaletra),
ritonavir (Norvir), saquinavir (Fortovase), and nelfinavir
(Viracept).
The doses of anti-HIV drugs that babies and children receive are
different to those given to adults. The dose may increase as
children grow. Babies and children's bodies process drugs more
quickly than adults. Children might also need to take larger doses
of a drug than an adult. Children may also need drugs such as
antibiotics to prevent other kinds of infections.
Children will need to visit their healthcare providers often for
blood tests and physical exams. Some immunizations may be
different for infants or children with HIV/AIDS. Children whose
immune systems are very weak will not receive live virus vaccines
such as measles-mumps-rubella, varicella (chickenpox), and
rotavirus.
To work properly, anti-HIV drugs need to be taken at the right
time and in the right way. This can be hard for children. Kids may
not want to take bad-tasting medicines, or may not want to take
medicines in front of other people. Talking with healthcare
providers and support groups can help.
For more information, call the National Pediatric AIDS Network at
800-646-1001 or visit their Web site at http://www.npan.org/.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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