HIV (AIDS) In Children: Symptoms, Treatment And Prevention

HIV in children is an ailment that needs constant medical assistance to avert complications. According to an update by UNAIDS, around 1.8 million children below 15 years of age were affected by HIV (human immunodeficiency virus) in 2017. However, the report also highlighted that there had been a drop in new HIV infections among children by 8 percent since 2016 (1).

Yet, this doesn’t mean that the work against HIV in children is over. Parents still need to know how HIV affects children and how they can protect their children from the infection. This post gives you insight into the possible causes of HIV in children, its symptoms, treatments, and tips to prevent the infection in children.

What Is HIV?

Human immunodeficiency virus (HIV) is a virus that causes a condition called acquired immune deficiency syndrome or AIDS. The virus attacks the immune system, especially the CD4 cells, also known as white blood cells or T-cells that are an important part of the immune system. After infecting a person, the virus slowly destroys the body’s ability to fight infections.

How Do Children Acquire HIV?

Children can acquire HIV from the mother who has the infection, while they are in the womb or when they breastfeed (mother-to-child or vertical transmission). The virus can also transmit through the following:

• Blood transfusion, when an infected person’s blood is given to an otherwise healthy person

• Use of contaminated syringes at hospitals or for scarification (explained below)

• Sexual abuse, such as forced sexual interaction involving penetration

• Unprotected Sexual intercourse (especially among adolescents). An HIV infected person can transmit the virus to the partner.

• Scarification (scratching or scraping of skin for a permanent modification of the body such as tattooing and piercing), for which an infected needle is used (2)

Note that HIV cannot spread via:

• Sweat
• Saliva
• Sharing utensils, food, or clothes
  Insect bites

Knowing about the symptoms of this infection will help you seek medical intervention in time.

What Are The Symptoms Of HIV In Children?

The symptoms of HIV can be classified into mild, moderate, and severe, as explained in the following table (3):

Other symptoms that may indicate possible HIV infection include (5):

• Neurological dysfunction such as microcephaly (the head is smaller than normal), neurological impairment, hypertonia (decreased muscle tone causing rigidity in flexing and moving), delay in achieving developmental milestones, or mental confusion.

• Painful rashes with blisters on chest and back.

If a child with HIV develops AIDS, then he/she may show the following symptoms (6):

• Weight loss or difficulty in gaining weight
• Persistent rashes
• Swollen lymph nodes (a part of the immune system, which filters bacteria and viruses) (7)
• Chronic thrush (fungal infection of the mouth, skin, and fingernails) (8)
• Chronic diarrhea
• Prolonged fever
• Lack of energy
• Pelvic inflammatory disease
• Unusual infections
• Short-term memory loss

How Is HIV Diagnosed In Children?

HIV antibody testing is done in children aged 18 months and above, who may show signs of HIV infection or those who are born to HIV+ve mother  (5). The testing is usually done in two steps: a screening enzyme-linked immunosorbent assay (EIA) followed by the Western blot test for confirming the HIV antibody (9).

The EIA test involves testing of blood samples or oral fluid collected from the gums and cheeks of the patients to determine the HIV antibodies. The Western Blot test also involves blood testing by separating the blood proteins and identifying the protein that indicates HIV infection.

Both the tests must yield positive results to confirm the diagnosis. If the child gets exposed to HIV through other sources (such as infected needles or syringes, sexual abuse) and shows the symptoms, but the test results are negative, then the test must be repeated later.

Treatment must begin soon enough if the diagnosis confirms HIV infection.

How Is HIV Treated In Children?

Children with an HIV infection should get the treatment as early as possible. The treatment involves the administration of antiretroviral drugs, which can slow down the rate at which HIV weakens the immune system. The drug is available in the form of syrup for children, although they may not always be practical considering that they must be taken in large quantities and have to be always refrigerated owing to their short shelf lives, (2).

The antiretroviral drugs given to pregnant women in early pregnancy and to the baby at birth have been found to greatly reduce the chance of HIV infection in the infant (3).

Children below the age of 15 years can also get benefited by the administration of an antibiotic called co-trimoxazole, which can prevent  some childhood infections. It has been found to reduce the mortality rate in children with HIV by more than 40%.

Can Children With HIV Receive Routine Immunizations?

Yes. Immunization can prevent diseases in children with HIV infection, although their response to the vaccination may vary depending on their body’s immunity level. The WHO has come up with the below chart of immunizations that children with an asymptomatic or symptomatic HIV can or cannot take (10).

Source: WHO

In any case, it is best to consult the pediatrician before going ahead with any vaccination schedule for the child with HIV.

How To Prevent HIV In Children?

The infection has almost been eliminated in high-income countries thanks to timely prevention, testing, and treatment options. However, the situation is still grim in sub-Saharan
Africa and South Asian countries (2). Here are some measures to prevent HIV in children:

• The best way to prevent HIV in kids is to prevent mother-to-child transmission. The administration of antiretroviral drugs at the initial stage of pregnancy can help preserve the immunity, promote growth and development, and increase the life span. Also, children who acquired the infection perinatally and received drug therapy showed 80% or higher increase in the survival rate (2).

• If the mother is HIV positive when she is pregnant, the delivery is done through a c-section to prevent the baby from contracting the virus through the birthing canal.

• Such mothers must not breastfeed the baby and use alternatives instead (3).

• If the child wants to get a tattoo or piercing done, then make sure to contact a professional who follows all the safety guidelines with the equipment used for the procedure (6). Ideally, children under the age of 18 should avoid getting tattoos, although some parents might want to get the child’s ears or nose pierced.

• When your child is due to get a vaccination or an injection for any reason, ensure that the medical professional is using fresh and unused syringes to prevent transmission of infections.

Next, we answer some more commonly asked questions about HIV in children.

References

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