Pediatric human immunodeficiency virus infection and the acquired immunodeficiency syndrome: a health care crisis of children and families

Article Abstract:

Infection with human immunodeficiency virus (HIV) causes AIDS. The rate of pediatric HIV infection is increasing. It is generally acquired in two ways: by transfusion with contaminated blood products (especially among children with hemophilia), and from infected pregnant women to the unborn. It is estimated that, by the end of 1991, there will be 3,000 children under 13 years of age with AIDS. The increase in the proportion of women with AIDS will result in more HIV-infected infants. Unexplained delays in mental development and motor skills (such as walking) may signal HIV disease. On early examination, infected children are often found to have failure to thrive (grow), hepatosplenomegaly (enlarged liver and spleen), diffuse lymphadenopathy (disease of the lymph nodes), recurring bacterial infections, and chronic candidiasis (yeast infections). They often develop persistent diarrhea, pneumonia, thrombocytopenia (decreased numbers of platelets, cells necessary for blood clotting), and parotitis (inflammation of a salivary gland known as the parotid gland). Children with these common and uncommon symptoms should be screened for HIV infection. Adolescent cases of HIV infection are likewise increasing. The number of new cases is highest among 20- to 29-year-olds, and more cases occur in women than in men. This pattern of infection may be due to relaxed sexual standards, multiple sexual partners, unsafe sex, and the fact that women are at greater risk for sexually transmitted diseases. Pediatric AIDS is a family matter; the mother and her partner are frequently infected. Children with HIV infection are likely to be poor, from minority groups and broken homes, and to live in substandard housing in inner cities, with minimal, if any, contact with health care programs. Many questions of HIV and AIDS in children remain unanswered. Access to new drugs is limited and children are usually not included in drug trials. Do cases of pediatric AIDS respond to therapy in the same way as do adult AIDS cases? Can a fetus be protected from acquiring HIV from an infected mother? Priority must be given to the investigation of preventive strategies. Social support for these children and their families must be reinforced, and multidisciplinary teams should meet the needs of the whole child. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Pediatric acquired immunodeficiency syndrome, poverty, and national priorities

Article Abstract:

Human immunodeficiency virus (HIV) infection (which causes AIDS) and full-blown AIDS occur in children, primarily poor, minority children who are often from broken homes. In this group, HIV is transmitted vertically from mother to child; the mothers are likely to be drug abusers or to have had sexual relations with HIV-infected partners. Children with hemophilia are another group affected by HIV infection and AIDS due to transfusions with contaminated blood products. The prognoses of HIV-infected children appear to be improving as pediatricians develop greater diagnostic capabilities and massive antibiotic therapies to overcome the infections to which these children are prone. The support structure for HIV-infected children is fragmented, at times disorganized, dysfunctional, and often impenetrable. The largest clusters of cases of children with HIV infection and full-blown AIDS are in the New York-New Jersey metropolitan area, Miami, and other large urban centers. These areas are overwhelmed with economic problems, and the added burden of caring for these sick children is almost insurmountable. In addition, estimates are now suggesting that approximately 40,000 children will be orphaned by AIDS during the next decade. The children with AIDS and the those with HIV-infected parents need a system in which they receive continued and responsible health care. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Opportunistic infections

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Pediatric human immunodeficiency virus revisited

Article Abstract:

Significant gains have been made in the diagnosis and treatment of HIV infection among children, but the serious social problems facing infected children and their families remain largely unattended. As of May 1993, more than 4,000 cases of HIV infection in children had been reported to the Centers for Disease Control and Prevention. Most HIV-positive children were infected by their mothers who were themselves infected with HIV. Most HIV-positive children are poor, ethnic minorities living in large cities. Funding for the public medical care on which these children rely is in jeopardy, and most of the support services for infected children and their families operate on grant funds that are not guaranteed. These children suffer from the stigma of AIDS as well as the other ills of urban poverty: poor education, homelessness and family dysfunction.

Social aspects, HIV infection in children, Pediatric HIV infections

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