Children can also be infected with HIV/AIDS

Children can also be infected with HIV/AIDS

By Donya Betancourt

SANUR, Bali (JP): Right now there is an army of health
professionals at war, trying to save more lives from the most
deadly disease man has ever known, AIDS, the acquired
immunodeficiency syndrome.

It has been 20 years since the first AIDS case was first
described and diagnosed in the United States. Over the last 20
years, AIDS has become a global epidemic. In that time, 22
million people died worldwide.

According to data from the Joint United Nations Program on
AIDS (UNAIDS), 4.3 million children died because of the syndrome,
and there are now 36 million adults and children living with the
virus.

The World Health Organization (WHO) estimated that in the year
2000 alone, 5.3 million people were newly infected with the human
immunodeficiency virus (HIV), which causes AIDS, and over three
million died from the deadly virus. Of the 3 million, 500,000 of
them were children.

The real numbers are believed to be much higher because
certain governments refuse to participate in a serious AIDS
tracking and treatment program. Consequently, millions of
AIDS related deaths and infections of HIV go unreported
worldwide.

What is HIV or AIDS?

AIDS is a chronic, life threatening condition caused by HIV.
HIV enters your body and then damages or slowly destroys the
cells of your immune system. HIV interferes with your body's
ability to fight off viruses, bacteria and fungi that cause
disease. This makes you more susceptible to opportunistic
infections your body would normally resist.
A person has an HIV infection if he tests positive in a HIV-
antibody test and a person has AIDS if he has latter stages of
HIV infection plus its symptoms (at least one of the
opportunistic infections), such as pneumocystis carinii
pneumonia, CMV retinitis, toxoplasma encephalitis, herpes zoster
or tumors such as Kaposi's sarcoma -- rare diseases in a healthy
immune person.

Both the terms HIV and AIDS refer to the same disease.

One factor in the AIDS epidemic is the symptoms often do not
appear for up to 12 years after the initial infection. HIV was
initially believed to be dormant during the early phases. But
actually, HIV replicates itself rapidly during all phases of
infection.

What does HIV do to the human body?

The normal function of white blood cells is to destroy germs
that enter your body, which is coordinated by a type of white
blood cell known as CD4 lymphocytes.

Unfortunately, HIV destroys CD4 cells because HIV uses CD4 as
a target to enter the cells and then use the cell's genetic
machinery for self-replication. In the end, the number of CD4
cells you have progressively decreases, and you develop severe
immune deficiency. This means your body is no longer able to
effectively fight off viruses and bacteria that cause disease.

What are the signs and symptoms?

The symptoms of HIV and AIDS vary, depending on the phase of
infection.

Early phase: HIV infection begins by it multiplying in lymph
nodes and slowly destroying helper T cells. You may have no
symptoms at all or may develop a flu-like illness within two to
six weeks after being infected. The illness usually includes
symptoms such as fever, headache, sore throat, swollen lymph
nodes and a rash, and can be mistaken for other conditions. You
may not realize that you have been infected with HIV.

Middle phase: It may take up to eight to nine years before HIV
causes mild infections or chronic symptoms such as low-grade
fever, weight loss, diarrhea and swollen lymph nodes. During this
time, HIV is continuing to multiply and destroy immune cells.
This stage is called symptomatic HIV infection, previously known
as AIDS-related complex (ARC).

Late phase: Occurs about 10 or 11 years after the initial
infection. Immunity is severely damaged by the loss of helper T
cells and the body is susceptible to various opportunistic
infections or tumors.

More serious symptoms may begin to appear. The symptoms
include chronic diarrhea, weight loss, shaking night sweats,
persistent and unexplained fatigue, high fever for several weeks,
persistent headache or opportunistic infections. People with AIDS
are also at great risk of developing cancers, especially Kaposi's
sarcoma and lymphoma.

HIV positive children often fail to gain weight or grow
normally, develop severe diarrhea, chronic thrush, and severe
pneumonia with liver, spleen and lymph nodes enlargement. As the
disease progresses, they may have delayed mental and physical
development. Children are susceptible to the same opportunistic
infections as adults and may have severe forms of common
childhood illnesses such as ear infections (otitis media),
pneumonia and tonsillitis.

How is HIV spread?

Transmission of HIV primarily occurs by three routes. Sexual
transmission include anal or vaginal intercourse, or oral-genital
sex without a condom with an HIV-positive partner. If you already
have another sexually transmitted disease, you're at a much
greater risk of contracting HIV.

Men can infect women more easily than women can infect men
because of their organ structure. Women's organs are concentrated
inside the body so women should always insist on the use of
condom.

Parenteral transmission include blood transfusion, sharing
contaminated needles or accidental prick of a needle used by
someone with HIV.

The risk of acquiring HIV from blood transfusions, due to
specialized blood screening, is extremely small. In mother-to-
infant transmission, about a quarter to one-third of all
untreated pregnant women with HIV will pass the infection to
their babies.

Studies show that administering zidovudine (AZT) during
pregnancy reduces the chances of transmitting HIV to the baby by
50 percent to 70 percent. If AZT is combined with a caesarean
section, infection rates may be reduced to less than 2 percent.

How is HIV diagnosed?

HIV is usually detected by a screening test (ELISA), which
checks the blood for the presence of an antibody that fights HIV.
A positive result on the screening test is confirmed by another
test called Western Blot. Early detection of HIV infection allows
a greater chance to have appropriate treatment, thereby
preserving the immune system and preventing opportunistic
infections. It also should alert the person to avoid risky
behavior and possibly spreading the disease.

HIV tests can be administered at most hospitals, clinics or
doctors' offices.

When consulting with patients who are infected with sexually
transmitted diseases (STDs), at times I am reminded of an ostrich
with its head stuck in the sand. I am amazed at the number of
people I interviewed who believed they were immune to the
HIV/AIDS virus because of their nationality, religion or
spiritual beliefs.

There is no medical or scientific evidence that the HIV/AIDS
has the ability to discriminate whom it will infect. There is no
known cure for the HIV/AIDS virus. The global outbreak of the
HIV/AIDS virus is a concern to everyone, and everyone should
behave responsibly and not put himself or others at risk.
Prevention is once again the best medicine.

If you are sexually active, always use a condom and wash
yourself immediately afterward. If you are taking drugs, use a
clean needle and enter a rehabilitation center to help you quit
your addiction. If you are already infected and pregnant, by all
means, consult your health professional throughout your pregnancy
and do everything required to prevent your baby from contracting
the disease. This includes avoiding breastfeeding after birth.

I believe in the case of HIV/AIDS, it is true to say we need
to think globally and act locally.

Next week I will discuss how to treat and prevent AIDS in
children.

The writer is a pediatrician based in Sanur, Bali. Questions?
Contact her at drdonya@hotmail.com or
features@thejakartapost.com.