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hiv aids in children

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aids in child and management

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hiv aids in children

  1. 1. “Human Immunodeficiency Virus” H = Infects only Human beings I = Immunodeficiency virus weakens the immune system and increases the risk of infection V = Virus that attacks the body
  2. 2. “Acquired Immune Deficiency Syndrome” A = Acquired, not inherited I = Weakens the Immune system D = Creates a Deficiency of CD4+ cells in the immune system S = Syndrome, or a group of illnesses taking place at the same time
  3. 3.  H.I.V (Human Immunodeficiency Virus) is a unique type of virus (i.e. a retrovirus) that invades the T- helper cells (CD4 cells) in the body of the host (defense mechanism of a person).
  4. 4.  AIDS:acquired immunodeficiency syndrome is a disease of the human immune system caused by infection with human immunodeficiency virus.In children it is acquired perinatally or by vertical –maternal- infant trasmission.
  5. 5. According to WHO  2.3 million children below 15 years are affected i.e 7.7% of the world population  Globally 91% from vertical trasmission  5% from nosochrombial trasmission  4% from sexual abuse
  6. 6.  HIV virus  From mother to featus i.e during pregnancy,labor and delivery and breast feeding  Blood trasfusion  Sexual trasmission  RISK FACTOR  Advanced maternal disease  High maternal viral load  Prolonged rupture of membranes  Vaginal bleeding  During breast feeding
  7. 7. AGENT FACTORS:  “Human Immunodeficiency virus” There are two types of HIV. 1. HIV-1 2. HIV-2
  8. 8. HIV-1 HIV-2 HIV-1 is more common worldwide. HIV-1 is easily transmitted. HIV-1 is pathogenic in nature Duration of HIV-1 infection is quite long. HIV-1 is commonly seen in India. HIV-2 is found in West Africa, Mozambique, and Angola. HIV-2 is less easily transmitted. HIV-2 is less pathogenic. Duration of HIV-2 infection is shorter . HIV-2 is relatively rare and has not been reported from India.
  9. 9. Greater concentration: • Blood • Semen • CSP Lesser concentration: • Tears • Saliva • Urine • Breast-milk • Cervical and vaginal secretions
  10. 10. HOST FACTORS:
  11. 11. AGE • Most cases in between 20-49 years. • Rarely seen in childrens under 15 yrs. SEX • Seen in both males & females. • Mostly in homosexual and bisexual mens. HIGH RISK • Male homosexuals & heterosexual partners. • IV drug abusers, transfusion if infected blood IMMUNOLOGY • HIV virus infects and destroys T-helper cells. • It results in reduced cellular immunity.
  12. 12. • INTRAUTERINE • INTRAPRATUM • POSTPRATUM
  13. 13. Viral DNA is transcribed into mRNA Integrase inserts viral DNA into Host DNA RNA transcribes DNA by enzyme Reverse Transcriptase RNA enters the human cell HIV virus binds to CD4 receptors on surface of T cells. Due to etiological factors
  14. 14. Destruction of T- helper cells and immune response declines causing S/S. Host cell is killed as viruses are released and budding process starts. Polyprotein converts into genome n becomes permanent part of cell’s genetic structure. mRNA is translated into protein – polyprotein
  15. 15. INCUBATION PERIOD upto 6 years or more
  16. 16. WHO clinical staging system for HIV infection and related disease in children: 1. Asymptomatic stage(stage 1) 2. Symptomatic stage(stage 2) 3. AIDS(stage 3)
  17. 17. o Asmptomatic o Persistant generalized lyphadectomy
  18. 18. o Unexplained chronic diarrhoea o Severe persistant or candidiasis outside the neonatal peroid o Weight loss or failure to thrive o Persistant fever o Recurrent severe bacterial infection
  19. 19.  Aids defining opportunistic infections  Severe failure to thrive  Progressive encephalopathy  Malignancy  Recurrent septicemia or meningitis
  20. 20. OPPURTUNISTIC ORGANISMS
  21. 21.  Bacterial infections  Tuberculosis (TB)  Herpes Simplex  Herpes Zoster  Vaginal candidiasis  Hairy leukoplakia  Kaposi’s sarcoma
  22. 22. HERPES SIMPLEX HERPES ZOSTER LEUKOPLAKIA KAPOSI’S SARCOMA
  23. 23.  Pneumocystic carinii  Toxoplasmosis  Cryptococcosis  Coccidiodomycosis  Cryptosporiosis  Non hodgkin’s lymphoma
  24. 24.  Disseminated mycobacterium avium complex (MAC) infection  Histoplasmosis  CMV retinitis  CNS lymphoma  Progressive multifocal leukoencephalopathy  HIV dementia
  25. 25. CLINICAL: The WHO clinical case defines pediatric AIDS if the existence of at least two major signs associated with at least one minor sign in the absence of other known cases of immunosupression such as cancer or severe malnutrition or other recognized etiologies.
  26. 26. • Weight loss (10% of body wt) • Chronic diarrhoea • Prolonged fever or intermittent fever for over a month MAJOR SIGNS • Persistent cough over a month • Generalized dermatitis • Recurrent herpes zoster • Oropharyngeal candidiasis • Generalised lymphadenopathy MINOR SIGNS
  27. 27.  Persistant thrush  Lymphadenopathy  Hepatosplenomegaly  Chronic diarrhoea  Parotid gland enlargement  Leukopenia  Hepatitis  Cardiomyopathy  Nephopathy
  28. 28. SCREENING TESTS
  29. 29. Enzyme Linked Immunosorbent Assay (ELISA) • Screening test for HIV • Sensitivity > 99.9% Western blot • Confirmatory test • Specificity > 99.9% (when combined with ELISA)
  30. 30. Absolute CD4 lymphocyte count • Predictor of HIV progression • Risk of opportunistic infections and AIDS when <200 HIV viral load tests • Best test for diagnosis of acute HIV infection • Correlates with disease progression and response to HAART
  31. 31.  There is no curative treatment of hiv aids.no vaccine are available for prevention.so children should be protected from contacting the hiv infection  Immunization can be given to hiv infected infant and children i.e are hepatitis b,polio vaccine,mmr,bcg etc  Plenty of fluid should be provided  Nutriotional food shold be given
  32. 32.  Medication like antidiarrhoeal,antipyretics,analgesics,antitur sive drug shold be given.  Antiretroviral drugs is given when the child have signs of immunodepression or hiv associated symptomsi.e are didanosine,zalcilabine,staudine etc.these are used for prolongation of life.  Other drugs like prolease inhibitors,non nucleoside reverse transcriptase inhibitors is also given with antiretroviral combination therapy
  33. 33.  Antiretroviral treatment with combination therapy or post exposure prophylaxis to prevent hiv in children.  Vertical trasmission can be prevented by zidovudine prophylaxis to the infected pregant women antd to infant till 6 weeks of life.  Health education shold be given to people to avoidins blood brone hiv trasmission.  Provide specific prophylaxis for hiv manifestations.  Parent to child trasmission can be prevented by avoiding indiscrimate sexaul practices of adults.
  34. 34.  Heticulous screening of blood and blood products should be done before blood trasfusion.  Sterilized syringe and needle should be used for immunization.  Aseptic techniques should be used during delivery.  Promoting community awareness of spread of hiv infection for unsafe practices.
  35. 35.  Risk for infections related to immuodefiency rate.  Alterd nutrition related to anorexia,pain in abdomen.  Diarrhoea and dehydration related to enteric pathogens and infection.  Alterd pain related to advanced hiv diseases.  Fear and anxiety related to diagnostic and treatment procedures.  Knowledge deficit regarding trasmission of hiv infection.

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