This document discusses Acquired Immunodeficiency Syndrome (AIDS) in children. It defines AIDS as a fatal illness caused by the human immunodeficiency virus (HIV) that breaks down the body's immune system. The document notes that in 2002, an estimated 800,000 children under 15 were newly infected with HIV worldwide and 610,000 children died of AIDS. It provides classifications for HIV infection in children and discusses routes of transmission, clinical features, diagnostic evaluations, common conditions, complications, and nursing management of pediatric AIDS.

1. MR.SACHIN T.GADADE
M.SC (N) PEDIATRICS

4. INTRODUCTION
ACQUIRED IMMUNODEFICIENCY
SYNDROME IN CHILDREN :-
 In 1982, a clinical entity characterized
by profound loss of immune functions
associated with a depletion of CD4t
helper ‘T’ Lymphocytes, formally
designated Acquired Immune
Deficiency syndrome (AIDS) was
recognized. This syndrome is caused
by infection with the human
immunodeficiency virus (HIV).

5. DEFINATION :-
AIDS the acquired immune deficiency
syndrome is described as fatal illness
caused by retrovirus known as human
immuno deficiency virus (HIV) which
break down body’s immune
syndrome.

6. Incidence :-

 AIDS has now attained a form of unique pandemic with
America, Europe and Africa belong most affected and
Asia least affected.
 In the year 2002 an estimated 8,00,000 children under
15 years were newly infected with HIV, and 6,10,000 died
of the disease. At the end of 2002, an estimated 3.2
million Children were living with HIV/AIDS.

7. Classification :-
 In 1994, center for Disease Control, Atlanta,
revised the Classification as inflection status,
clinical status & immunological status. Once
included in a particular category, an HIV inflected
child cannot be reclassified LE a less severe
category even if the child's or immunological
status improves.

8. Immunological Categories:-
Immunological
Categories
Clinical Categories
No signs/
Symptoms
Mild
signals/
Symptoms
Medacate
signs/
Symptoms
Severe
signs/
Symptoms
(N) (A) (B) (C)
1)No evidence of
suppression
N1 A1 B1 C1
1)Evidence of moderate
suppression
N2 A2 B2 C2
1)Severe suppression N3 A3 B3 C3

9. Etiology :
 The majority of children with HIV
infection are younger than 7 years of age.

10. Children with HIV fall into
two sub populations :-
 Infants born to HIV inflected women and
adolescents infected as a result of high risk
behaviors.
 The transmission of HIV can occur in utero,
intrapartum, or after delivery through breast-
feeding.
 Maternal risk factors – e.g.- viral lead, stage of
diseases.
 HIV is not transmitted by food, water,
mosquitoes or casual contact. (i.e..- Social
kissing, Shaking hands & hugging)

11.  Factors that increase the rate of mother to children
transmission include high level of viremia & lack of matching
antibody in the pregnant woman.
 Advanced maternal HIV disease.
 Low maternal CD4 counts.
 Maternal P24antigenemica.
 High CD8 counts, pre mature infants
 in born twins.
 Lack of anti-viral therapy to inflected pregnant woman.

12. Clinical Features :-
They are classified into 2 types
 Acute Phase
 Clinical Latency /chronic phase

13. Acute Phase –
 Swealing
 Generalised Red Rash
 Difficulty in Breathing

14. Clinical Latency /chronic
phase
 Fever
 Weight loss
 Malaise
 Pain
 Fatigue
 Loss of Appetite
 Abdominal Discomfort

15.  Abdominal Discomfort
 Diarrhea
 Night Sweat
 Headache
 Swollen lymph Glands

16. Common Clinical Manifestation of Human
Immunodeficiency Virus infection in
Children.
 Lymphadenopathy
 Oral Candidiasis
 Chronic or recurrent diarrhea
 Failure to thrive
 Developmental delay
 Parotitis

17. Common deficiency
Conditions for AIDS in
Children
 Pneumocystis carinii pneumonia
 Lymphoid interstitial pneumonia
 Bacterial infection
 Pulmonary Candidiasis
 Herpes simplex disease
 Weight loss of more than 10% of body weight.

18. Diagnostie Evaluation :-
 ELISA :- Comes positive
 Western blot test – confirmatory test for
HIV antibodies
 Radio-immuno precipitation test (RIP)
 This test detects HIV protein more
sensitive's & specific than western blot.
 HIV Tracking- P24 antigen test
 This test a confirmatory test in HIV
patients
 Polymerase chain Reaction – This will help
in detection of HIV RNA or DNA.

19.  Guantative cell calture :- This measures viral
load within the cells.
 Immune Status :- CD4 Count ratios.
 CBE – To identity anemia thrombocylopenia,
leucopenia urine Analysis – To renal, Liver,
Metabolic or Nutritional.
 Monloux Test – To detect TB
 Chest X-Ray – To identity polmonary problems
 For Women – A pregnancy & test popanco
loaus test.

20. Complications of AIDS :-
 Brain= Tumors especially lymphomas
encephalitis & dementia, meningitis,
 G.I. tract =Candidiasis of mouth, trachea,
Esophagus
 Lungs =Pneumocystis Carinii infection,
tuberculosis & other fungal infection.
 Intestines= Protozoa salmonella infections
Causes Chronic diarrhea.
 Skin= Kaposi's sarcoma (Cancers) fungal
infection like herpes zoster herpes simplex.

22. Nursing Management of AIDS
 Assess level of activity tolerance & degree of
fatigue, Lethargy and malaise
 During the period of fatigue advise the client
strict bed rest
 Assist the activities & hygiene when antique
 Maintain nutritional & fluid balance
 Provide vitamin supplements
 Prevent infection & injury.
 Modify alterations in body temperature.
 Reducing anxiety

23. Nursing Diagnosis of AIDS –
 Ineffective airway clearance related to pneumocystis carinii
pneumonia, increased bronchial secretions & decreased
ability to cough related to weakness & fatigue.
 Ineffective breathing pattern related to severe respiratory
tract infections.
 High risk for infections due to loss of immunity
 Fluid volume deficit related to loss of body fluids, decreased
intake vomiting, diarrhea, nausea.

24.  Altered nutrition less body requirements related
anorexia, nausea diarrhea & vomiting.
 Social isolation related to grieving fear of death, fear of
infecting others in family & society.
 Knowledge deficit – regarding unfamiliarity with
information sources & rehabilitations.