HIV Flashcards
Number of children with hiv
3.2 million, 2.9 million in subsaharan Africa
Estimated number of deaths from AIDS per year in these children?
190 000
What proportion of children born with HIV die within their first year of life and second year without treatment?
1/3 and 1/2
How do you reduce HIV-related mortality in children by 75%?
By initiating antiviral therapy before the 12th week of life.
Why are children and pregnant women living with HIV left behind? 4 main reasons.
- Limited access to sexual and reproductive health and HIV services.
- Limited access to HIV-treatment
- Failure to prioritize children
- Poorly integrated health-care services
Do children with HIV receive antiviral therapy to the same extent as adults?
No. Children are 1/3 less likely to receive therapy.
Maternal risk factors for mother-child transmission of HIV?
- Viral load - strongest predictor
- Symptoms
3- CD4 count
Child risk factors for mother-child transmission of HIV?
- Prematurity = higher risk
2. Genetic factors
Other risk factors for mother-child transmission of HIV?
- Means of delivery, the more trauma the higher risk.
- Time from amniotic retirement
- The amount and type of the HIV-virus
Risk of in utero transmission? without treatment.
Less than 20%. Can vary depending on the type of virus.
Risk of transmission during vaginal delivery?
80%
Risk of transmission during breastfeeding?
10-15%
How can you decrease the risk of transmission to 1%
- optimal ART treatment during pregnancy.
- Elective sectio (week 38)
(3. IV treatment during delivery or sectio if HIV RNA >50 or prematurity) - optimal treatment of the child for 4 weeks.
- No breast feeding
Clinical findings which may suggest HIV infection in children?
- Protracted oral candidosis
2. Parotitis/swelling of parotis
Laboratory findings which may suggest HIV infection?
- Hypergammaglobulinemia
2. Lowered CD4% count
When is ART recommended?
All infants with verified HIV infection should be treated with 3 active antivirals. However, early start of treatment may prevent the development of antibodies and thus regular HIV-tests may be negative in spite of infection.
When is the risk for HIV-transmission negligible?
With optimal treatment and HIV-RNA
What is hairy leukoplakia?
White patch on the side of the tongue with a corrugated or hairy appearance. Caused by EBV in immunocompromised patients, such as HIV/AIDS.
What is Kaposi’s sarcoma?
Tumour caused by the HHV8. Most commonly appears early on the toes and soles as reddish, violaceous, or bluish-black macules and patches that spread and coalesce to form nodules or plaques.
One of the AIDS defining diseases.
What is PML?
Progressive multifocal leukoencephalopati. Caused by JC-virus in the immunocompromised.
What is toxoplasmosis?
Infection caused by toxoplasma gondii. Usually asymptomatic in adults. Can cause severe disease in the immunocompromised, seizures due to cerebral lesions.
Varför måste man ALLTID behandla opportunistic infections innan man påbörjar ART?
För annars kan man få immune reconstitution inflammatory syndrome (IRIS) där immunförsvaret börjar återhämta sig o överreagerar på opp infektionen.
