Muhammad Reza, MD(Paed)

Care for us and accept us we

are all human beings. We are
normal. We have hands. We
have feet. We can walk, we can
talk, we have needs just live
everyone else dont be afraid of
us we are all the same!
- An Aids Patient

"Helping kids understand about

AIDS is the most important thing
I do. Some kids like to pretend
that it's not happening in the
world. By letting them know
what's really going on, I might
save someone's life.
Hydeia L. Broadbent
AIDS patient and activist.

WHAT IS H.I.V????
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

WHAT IS AIDS?????
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

DEFINITION

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).

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 maternalinfant trasmission.

Every minute five people around the world between the

ages of 10 and 24 are infected with HIV.

There are 2.5 million children under the age of 15

living with the disease worldwide.

In Sub-Saharan Africa, the majority of new infections

occurs among young people between the ages of
15 and 24.
The total number of children orphaned by AIDS 26.4
million as of 2010 is expected to more than
double by 2015.
Of the 3 million who died of AIDS in 2013, 500,000
were children.

NEWS 11
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| Aids Out Life In | Children Infected & Affected |

INCIDENCE
According to WHO
2.5 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

North America
20000

Western Europe
10000

Eastern Europe
24000

Pacific
6000

Caribbean
40000

North America &

Middle East
80000

Central Asia
40000

South East Asia

420000

Latin America
85000

Africa
5.6 Million

East Asia
8500

Aus&NZ
6000

Children (<15 Years) estimated to be living with HIV/AIDS as of end of 2013

Why do
Children have
HIV/Aids

Most children under 15 who have

HIV/AIDS are infected through
their infected mothers that is,
through mother child
transmission...this occurs during
pregnancy, birth, or breastfeeding
after birth.
Sexual activity (the main route of
disease transmission) starts in
adolescence for most people
worldwide.
Young people who are uninformed
about HIV/AIDS transmission risk
becoming infected.
Poverty, lack of education, lack of
medical resources, and the
commercial sexual exploitation of
children also help spread HIV/AIDS
among children worldwide.

CAUSES

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

EPIDEMIOLOGICAL FEATURES
AGENT FACTORS:

Human Immunodeficiency virus

There are two types of HIV.

1. HIV-1
2. HIV-2

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.

SOURCE OF INFECTION
Greater concentration:
Blood
Semen
CSP

Lesser concentration:

Tears
Saliva
Urine
Breast-milk
Cervical and vaginal secretions

How are Children affected?

How are
Children
affected?

Children with HIV/AIDS have weaker immune systems and are more
susceptible to other illnesses.
Children with HIV/AIDS may be stigmatized and/ or rejected from
their families and communities.
this discrimination fosters ignorance about HIV/AIDS and stigma
against testing for, treating the disease. This in turn makes it difficult
to prevent the spread of HIV/AIDS.
Children are orphaned when their parents die from HIV/AIDS.

TIMING OF HIV TRASMISSION

INTRAUTERINE

INTRAPRATUM

POSTPRATUM

PATHOPHYSIOLOGY
Due to etiological factors

HIV virus binds to CD4 receptors on surface of T cells.

RNA enters the human cell
RNA transcribes DNA by enzyme Reverse Transcriptase
Integrase inserts viral DNA into Host DNA
Viral DNA is transcribed into mRNA

PATHOPHYSIOLOGY
mRNA is translated into protein polyprotein

Polyprotein converts into genome n becomes permanent

part of cells genetic structure.

Host cell is killed as viruses are released and budding

process starts.

Destruction of T- helper cells and immune response

declines causing S/S.

CLINICAL FEATURES
WHO clinical staging system for HIV infection
and related disease in children:
1.
2.
3.

Asymptomatic stage(stage 1)
Symptomatic stage(stage 2)
AIDS(stage 3)

STAGE 1- ASYMPTOMATIC INFECTION

o
o

Asmptomatic
Persistant generalized lyphadectomy

STAGE 2 - SYMPTOMATIC STAGE

o
o
o
o
o

Unexplained chronic diarrhoea

Severe persistant or candidiasis outside the
neonatal peroid
Weight loss or failure to thrive
Persistant fever
Recurrent severe bacterial infection

STAGE 3- AIDS

Aids defining opportunistic infections

Severe failure to thrive
Progressive encephalopathy
Malignancy
Recurrent septicemia or meningitis

IF CD4<500

Bacterial infections
Tuberculosis (TB)
Herpes Simplex
Herpes Zoster
Vaginal candidiasis
Hairy leukoplakia
Kaposis sarcoma

IF CD4< 200

Pneumocystic carinii
Toxoplasmosis
Cryptococcosis
Coccidiodomycosis
Cryptosporiosis
Non hodgkins lymphoma

IF CD4 <50

Disseminated mycobacterium avium complex (MAC)

infection

Histoplasmosis

CMV retinitis

CNS lymphoma

Progressive multifocal leukoencephalopathy

HIV dementia

DIAGNOSIS
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.

OTHER SIGNS AND SYMPTOMS

Persistant thrush

Lymphadenopathy

Hepatosplenomegaly

Chronic diarrhoea

Parotid gland enlargement

Leukopenia

Hepatitis

Cardiomyopathy

Nephopathy

BLOOD DETECTION TEST

TREATMENT

MANAGEMENT

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 shuold be given

Medication like
antidiarrhoeal,antipyretics,analgesics,antitu
sive drug shold be given.
Antiretroviral drugs is given when the child
have signs of immunodepression or hiv
associated symptoms. these are used for
prolongation of life.
Other drugs like prolease inhibitors,non
nucleoside reverse transcriptase inhibitors is
also given with antiretroviral combination
therapy.

PREVENTION

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 pregnant
women and to infant till 6 weeks of life.
Health education should be given to people to
avoid blood brone hiv trasmission.
Provide specific prophylaxis for hiv
manifestations.
Parent to child trasmission can be prevented by
avoiding indiscrimate sexaul practices of adults.

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.

NURSING DIAGNOSIS

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.

What can
we do?

Advocate for HIV/AIDS

awareness!
Begin a social
awareness/human
rights club.

Educate
yourself about
HIV/AIDS.

Contact local, state, and national

politicians for support for
HIV/AIDS.
Write letters asking for their
opinion on HIV/AIDS.

Talk to your parents

about HIV/AIDS.
Educate the adults in
your life!

Be Safe! This could be

your Child.

AIDS.org
www.aids.org
Center for Disease Control
www.cdc.gov
AIDS Alliance for Children, Youth &
Families
www.aids-alliance.org
Population Services International
www.youthaids.org
UNAIDS
www.unaids.org
UNICEF
www.unicef.org/aids
Youth Advocate Program
International
www.yapi.org

For more
Information

ANY DOUBTS??

Muhammad Reza, MD(Paed)

reza.paed@gmail.com