Text VIII. HIV

Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). Vertical transmission from mother to infant accounts for the majority of HIV infected infants in the world. It may also be transmitted by transfusion of blood and blood products.

Pathogenesis:

-HIV + mother secondary to drug abuse, sexual contact with HIV + male;

-transmission by way of blood products (now reduced with efficient screening);

-unclear whether infections occur primarily by inoculation at time of birth.

Infected infants are often asymptomatic at time of birth. Recurrent infections, severe intractable diarrhea and failure to thrive are common clinical manifestations which may present shortly after birth.

Serology cannot be relied upon at birth. Polymerase chain reaction detection of HIV antigen in infant’s lymphocytes is strongly indicative of “true” infection in infant.

Management: good nutritional support; pneumocystis carinii prophylaxis; IV gamma globulin for antibody deficiency; antiviral prescription – AZT, DDI, others; anti-infective agents for treatment of infection.

Questions:

1. What is HIV?

2. How can it be transmitted?

3. What is clinical course of HIV in infants?

4. What does treatment of this disease consist of?