How Do Most Children Get HIV?
HIV (human immunodeficiency virus) can be transmitted from a parent who has HIV to their child during pregnancy, childbirth, or through breast milk, which is known as perinatal transmission of HIV.
This is how most children below the age of 13 in the United States contract HIV. Perinatal transmission of HIV is also referred to as vertical transmission of HIV in children.
Thanks to the use of HIV medicines and preventive measures, the rate of HIV spreading from mother to child in places like the United States and Europe has dropped to one percent or less. This is a big success and shows that early care and treatment really help.
What Factors Affect HIV Treatment in Children?
Everyone with HIV, including children, should take HIV medicines (called antiretroviral therapy, or ART). HIV medicines keep people with HIV healthy and cut down the chances of passing on HIV.
When doctors treat children, they have to consider how fast the child is growing and developing. Because children grow at different rates, doctors often decide the medicine dose based on the child’s weight, not just the age.
Younger children who cannot easily swallow pills may be given liquid forms of HIV medicines. But sometimes, children have trouble taking their medicine every day and at the right time. These challenges are called barriers to medication adherence (things that make it hard to take medicine correctly).
The most important part of HIV treatment is how well a child follows the doctor’s instructions and takes medicine regularly. Skipping doses can make the medicine less effective and can allow the virus to grow stronger.
Why Is Medication Adherence Difficult for Children?
Taking medicine every day is hard for many children with HIV. There are many reasons for this. Some children do not like the taste of their medicine, while others may forget to take it on time.
The following factors can also affect medication adherence in children:
A parental schedule may prevent them from taking their HIV medicines on time every day.
Physical side effects of HIV-related drugs.
Family problems that are not limited to major illness, such as issues within the family/home, homelessness, or substance abuse.
No health insurance for the cost of HIV medicines.
The child’s age and stage of development can affect how well they understand the need for daily medicine.
How Is HIV Diagnosed in Children?
Children with HIV must be tested as early as possible and diagnosed accurately to minimize the spread of AIDS transmission rates, as well as to give the child an early chance for treatment to avoid advancing to the AIDS stage.
The following tests are done to diagnose HIV in children:
Virologic Assays (HIV RNA or HIV DNA NATs): In children under 18 months of age who are considered born to HIV-positive mothers, HIV RNA (ribonucleic acid) or HIV DNA (deoxyribonucleic acid) NATs (nucleic acid amplification tests) are required for diagnosis of HIV.
These tests look for the virus itself in the blood, not just antibodies. Antibody tests are not useful at this age because babies may still have their mother’s antibodies even if they are not infected.
Testing schedule for infants
At birth, PCR (polymerase chain reaction) testing is mandatory for all infants with perinatal exposure, regardless of maternal HIV symptoms, unless the child is considered at low risk (as when the parent has an HIV RNA level below 50 copies/mL during pregnancy).
14 to 21 days.
1 to 2 months.
4 to 6 months.
If the baby is taking preventive HIV medicine, more tests are done two to six weeks after stopping that treatment. A positive result must always be confirmed with another test.
Exclusion of HIV in Non-Breastfed Infants
Two or more negative tests are answered during the visit, at least one of which is at least one month old, and all of which are at least four months from a positive test.
Alternatively, two negative serological tests performed six months apart will exclude the diagnosis. Because such children do not need to be tested routinely and have no other HIV-containing fluid exposure, they should consume only non-breastfed infant formula.
Testing during breastfeeding
At 14 to 21 days, one to two months, and four to six months.
Every three months while breastfeeding.
Again, four to six weeks and four to six months after breastfeeding stops.
HIV in Older Children and Teenagers
For children older than 18 months, doctors use antibody or antigen/antibody tests to check for HIV. If the test result seems unclear or the infection is very recent, doctors use NATs for confirmation.
Teenagers with HIV may show signs like long-lasting fever, swollen glands, tiredness, and weight loss. Since HIV spreads easily, early recognition of symptoms and testing is extremely important for starting treatment and preventing transmission.
How Is HIV Treated in Children?
During treatment for children with AIDS or HIV, doctors suggest a mix of antiretroviral medicines, no matter the child’s age. These medicines reduce the viral load (the amount of HIV in the blood) to levels so low that it cannot be spread to others.
Children need to take their HIV medicine every day as the doctor advises. Doing this helps prevent drug resistance (when the virus stops responding to medicine) and keeps the immune system strong.
If a child struggles to take medicine regularly, parents should talk to the doctor. Doctors can help find ways to make it easier, such as changing the medicine type or using reminders.
Sometimes, teenagers may get HIV through sexual activity, sharing needles, or sexual abuse. In such cases, doctors can give post-exposure prophylaxis (PEP), a medicine taken soon after contact with HIV, ideally within 72 hours. PEP is very effective if started quickly.
For teenagers at high risk of getting HIV, doctors may recommend pre-exposure prophylaxis (PrEP), a daily medicine that helps prevent infection before exposure.
Conclusion
This HIV epidemic is now in its third decade. There are better treatments that allow the sufferer to live longer, but there is still no cure for the disease. Development of an effective and safe vaccine against HIV is still elusive.
In recent years, HIV cases have gone up, especially among pregnant women. This has led to more babies being exposed to the virus before they are even born. When HIV is not treated in children, the disease can progress very quickly, and sadly, many may die before the age of two. However, some children live longer, and about one-third of them can survive ten years or more, even without proper medical care.
Prevention is the main component of curing the disease. More public health programs should be initiated to increase awareness of the human immunodeficiency virus.
iCliniq Takeaways
With early testing and proper treatment, children and teenagers living with HIV can grow up strong and healthy. The right care helps keep the virus under control and protects their future.
If any child you know may be at risk or has tested positive for HIV, talk to our experienced HIV doctors at iCliniq.com for guidance and support.
Early testing and diagnosis have proven to be very important in helping them live longer and healthier lives.
