HIV TRANSMISSION SEXUAL PARENTERAL VERTICALCONTACT CONTACT WITH TRANSMISSION FROM BLOOD MOTHER TO CHILD Most important mechanism of infection, responsible for over 90% of cases.
The vertical transmission rate, withouttherapeutic intervention, varies indifferent countries: The United States and Europe between 12 and 30%. In Africa and Haiti is higher, between 25 and 52%.
Vertical transmission can occur duringpregnancy (intrauterine), during labor andchildbirth (intrapartum), or in the postnatalperiod, through breastfeeding.
It is given by transfusion ofblood and bloodproducts, risk is virtuallynonexistent today becauseall donated blood issubjected to analysis andrisk donors are discarded.In child sexual contacttransmission is rare, butthere is risk of infectionthrough sexual abuse.
TREATMENTTreatment of HIV-infected children is complicated by all family and socialissues involved.Is important to have a multidisciplinary team, involving nurse, socialworker, physiotherapist, nutritionist and, if possible, a psychiatrist orpsychologist.
The specialty of Pediatricsfocuses its activities on thediagnosis and treatmentof diseases of childrenfrom birth throughadolescence.
vaccines Inchildren should receive vaccinations exampleexpanded immunization program (EPI) BCG vaccineaccording to the usual pattern alsoIt´s recommends the use of othervaccines pneumococcal infections influenza hepatitis B
Respect of antiretroviral therapy, the decision at thebeginning of this therapy is based on several aspects suchas clinical manifestations, the childs age, the CD4 recountand viral load.
The present tendency isto use at least threedrugs, whose selectionwould be consideredoral tolerance to thedrug, its presentation, itsinteraction with otherdrugs, toxic effects, andmost importantly, theavailability of the drug atthe time.
At present, there are anumber of availableantiretroviral drugswith differentmechanisms ofaction, several of themaccepted for pediatricuse.