Paediatric HIV - trends & challenges.
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Date
2011-12
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Abstract
With the availability of antiretroviral therapy (ART), HIV infection, which was once considered
a progressively fatal illness, has now become a chronic treatable condition in children, as in adults.
However, the challenges these children are forced to face are far more daunting. The most significant
shortcoming in the response to paediatric HIV remains the woefully inadequate prevention of motherto-
child transmission (PMTCT), allowing a large number of children to be born with HIV in the first
place, in spite of it being largely preventable. In the west, mother-to-child transmission has been virtually
eliminated; however, in resource-limited settings where >95 per cent of all vertical transmissions take
place, still an infected infants continue to be born. There are several barriers to efficient management:
delayed infant diagnosis, lack of appropriate paediatric formulations, lack of skilled health personnel,
etc. Poorly developed immunity allows greater dissemination throughout various organs. There is
an increased frequency of malnutrition and infections that may be more persistent, severe and less
responsive to treatment. In addition, these growing children are left with inescapable challenges of facing
not only lifelong adherence with complex treatment regimens, but also enormous psychosocial, mental
and neuro-cognitive issues. These unique challenges must be recognized and understood in order to
provide appropriate holistic management enabling them to become productive citizens of tomorrow.
To address these multi-factorial issues, there is an urgent need for a concerted, sustainable and multipronged
national and global response.
Description
Keywords
Challenges, clinical diagnosis, clinical manifestations, early infant diagnosis, immunization in children with HIV, management, nutrition, psychosocial issues, paediatric HIV, trends
Citation
Mothi S N, Karpagam S, Swamy V H T, Mamatha M Lala, Sarvode S M. Paediatric HIV - trends & challenges. Indian Journal of Medical Research. 2011 Dec; 134(6): 912-919.