Not only in adults, but the disease also affects infants and children. Each year, hundreds of children from around the world are infected with HIV and dying from AIDS because they do not receive appropriate treatment.In the world, every day, about 2,000 children under the age of 15 years due to transmission from infected mother to her baby, about 1,400 children under the age of 15 years died of AIDS, while about 6000 people in the productive age between 15-24 years are infected with HIV .
Transmission of HIV in children could be prevented. Prevention program was implemented in the high-income countries, which are ready in HIV prevention. Services to detect and treat HIV has reduced mother-to-child transmission of up to 2% and increased survival of HIV-infected infants. In Indonesia, the control program has made HIV / AIDS by the Ministry of Health in 2007. In addition, the Department of Health is also working with IDAI (Pediatric Association of Indonesia) to handle cases of HIV / AIDS on children, although there are still many obstacles and challenges to be faced.
What is HIV and AIDS?
HIV stands for Human Immunodeficiency Virus, the virus that attacks the human immune system. The virus causes AIDS (Acquired Immune Deficiency Syndrome) or acquired immune deficiency syndrome. AIDS is characterized by serum and HIV positive, and had clinical symptoms associated with AIDS, including opportunistic bacterial infections (bacteria which actually does not cause disease in a normal person), or complications in the nervous system, lungs or heart.
How babies and children can be infected with HIV?
Mother-to-child transmission (mother to child transmission) play a major role in the spread of HIV in children. If a woman is HIV-infected and pregnant, then the chances are the baby will become infected during pregnancy or while giving birth vaginally (normal). In addition, HIV can also be transmitted through breast milk.
Apart from mother to child transmission, some children may be exposed to HIV in a hospital or other medical situations, for example through a needle that has not sterile or through blood transfusion infected with HIV. In countries with more developed, these problems have been overcome, but in the scope of a resource-poor it is still an important issue. In older children, sexual activity and drug use is also a risk for HIV infection.
Symptoms of HIV-infected children
Most children with HIV did not gain weight but can also grow normally. Motor skills and mental development often lags behind normal children such as crawling, walking and talking. Along with the development of the disease, many children have nervous system problems such as difficulty walking, poor school performance, seizures, and symptoms of HIV encephalopathy (brain abnormalities). As well as adults who have been infected with HIV, children with HIV infection may also be affected by other life-threatening germs, even though the number of events are different from adults. Among them:- Toxoplasmosis (parasitic diseases), more common in children than adults.
- Pneumocystis carinii pneumonia (PCP), which is the leading cause of death in children infected with HIV or AIDS
- Lung disease called lymphocytic interstitial pneumonitis (LIP). Rarely in adults, more often in children. It can cause breathing difficulties such as PCP progressive and usually must be treated.
- Severe candidiasis (yeast infection), which can cause diaper rash (diaper rash), and infections of the mouth and throat which causes difficulty in eating
- When it got worse, HIV-infected children may experience chronic diarrhea due to opportunistic infections / other germs.
Children with HIV suffer from infectious diseases that commonly occur in children more often and more severely than uninfected children. Such infections can cause seizures, pneumonia, recurrent colds, diarrhea, dehydration and other problems that can cause the child to be treated in hospital longer and a nutritional problem.
Diagnosis?
Generally for diagnosing HIV infection in children is very difficult, because in the early months of life, babies can look healthy and normal. To ensure the necessary laboratory diagnosis right. HIV antibody test to detect antibodies to HIV.
Infants born to mothers with HIV will have HIV antibodies acquired from the mother via the umbilical cord, and persist in the blood of infants up to age 18 months (also called maternal antibodies). Because maternal antibodies showed maternal HIV infection status, not the baby, the HIV antibody test is not very useful in newborns and infants under 18 months of age.
Lately, found the examination to diagnose HIV infection in infants aged 6 months or less. This examination is called a PCR (polymerase chain reaction) HIV and can be done at any age.
Early diagnosis is critical, because a state of severe immunodeficiency and life threatening can happen quickly. Optimal governance of HIV infection in infants and children, the diagnosis requires timely and accurate.
Treatment
Infants and children who have been infected with HIV should be treated by a pediatrician who know about HIV. Treatment of HIV positive infants and children is very difficult, but there are several treatment options available.
Antiretroviral therapy (ART) works very well in children, the mortality rate of HIV-infected children decreased as much as for adults. Determining the right time to initiate therapy in children is difficult. Therapy faster to prevent damage to the immune system. Nevertheless, the provision of antiretroviral drugs is not an emergency. What is important in the treatment of pediatric HIV is that medication adherence is key to successful treatment of HIV-infected children and prevent resistance (resistant to medication).
How to Prevent?
Because transmission from mother to child major role in the spread of HIV in children, the main way to prevent HIV-infected children is the prevention of HIV transmission from mother to child.
Prevention of mother-to-child transmission (prevention of mother to child transmission of HIV / PMTCT) is done to reduce the rates of HIV infection in children. The program covers HIV screening for pregnant women, provision of antiretroviral agents in HIV-positive pregnant women, and nursing care at birth. In pregnant women with HIV, the delivery process should be by Caesarean section.
In addition, because the HIV virus can be transmitted through breast milk, it should be replaced with formula milk, and do not incorporate the provision of both.
There are some that can be done on the immunization of infants and children infected with HIV. It is better to consult with your pediatrician before giving immunizations.
Parent-child HIV
Many parents are worried their children may infect others. HIV-infected people do not live together, play, school, or share food / toys with someone who is infected with HIV. Animals and insects do not transmit HIV. The HIV virus can die easily when they are outside the human body. Even so, it still needs to maintain the hygiene and cleanliness of the body, such as washing hands with soap, because it could be an infection from bacteria or other viruses.
That needs special attention is the blood, such as cleaning wounds, need to wear personal protective equipment such as gloves. Or if exposed / exposed blood splashes, immediately wash with water as soon as possible.
When there is blood on clothing, wash it in cold water first, then use detergent as usual. HIV infection is not transmitted through saliva, so equipment such as baby bottles and tableware can be washed and sterilized as usual.
Spots of blood on the floor or furniture can be cleaned with a cloth or disposable wipes and dispose of in a plastic bag. Use warm soapy water to clean the affected area, and remove cloth / tissue as usual.
It should be noted by parents that the drug must be right. There are several problems that can occur in this instance, provision of drugs that do not conform to the school schedule or play. Administration of drugs in public or social situations can cause embarrassment and emotional stress. Vacation or trip can also cause difficulty giving the right medicine. These things should be anticipated well and need to plan for the future.