HIV In Infants and Children | BlackDoctor

    HIV In Infants and Children

    HIV Infection in Infants and Children

    National Institute of Allergy and Infectious Diseases (NIAID) has a lead
    role in research devoted to children infected with HIV (human
    immunodeficiency virus), the virus that causes AIDS (acquired
    immunodeficiency syndrome). NIAID-supported researchers are developing
    and refining treatments to prolong the survival and improve the quality
    of life of HIV-infected infants and children through the Pediatric AIDS
    Clinical Trials Group (PACTG). The PACTG is a nationwide clinical trials
    network jointly sponsored by NIAID and the National Institute of Child
    Health and Human Development (NICHD). NIAID also supports research on
    ways to prevent mother-to-child transmission (MTCT) of HIV through the
    PACTG and its HIV Prevention Trials Network (HPTN), a global clinical
    trials network designed to test promising nonvaccine strategies to
    prevent the spread of HIV/AIDS.

    In this era of antiretroviral therapy, epidemiologic studies such as
    NIAID’s Women and Infant’s Transmission Study (WITS) are examining risk
    factors for transmission as well as the course of HIV disease in
    pregnant women and their babies. Researchers have helped illuminate the
    mechanisms of HIV transmission, the distinct features of pediatric HIV
    infection, and how the course of disease and the usefulness of therapies
    can differ in children and adults.


    According to UNAIDS (The Joint United
    Nations Programme on HIV/AIDS) at the end of 2003, an estimated 2.5
    million children worldwide under age 15 were living with HIV/AIDS.
    Approximately 500,000 children under 15 had died from the virus or
    associated causes in that year alone. As HIV infection rates rise in the
    general population, new infections are increasingly concentrating in
    younger age groups.

    December 2003 UNAIDS/World Health Organization (WHO) worldwide statistics show

    • 700,000 children under age 15 were newly infected with HIV
    • Thirteen percent of all new HIV infections were in children under age 15
    • Three million children in sub-Saharan Africa, the region with the highest number of cases, are living with HIV

    More than 95 percent of all HIV-infected people now live in
    developing countries, which have also suffered 95 percent of all deaths
    from AIDS. In those countries with the highest prevalence, UNAIDS
    predicts that, between 2000 and 2020, 68 million people will die
    prematurely as a result of AIDS. In seven sub-Saharan African countries,
    mortality due to HIV/AIDS in children under age five has increased by
    20 to 40 percent. Life expectancy for a child born in Botswana, the
    country with the highest HIV prevalence in the world, has dropped below
    40 years-a level not seen in that country since before 1950.

    The United States has a relatively small percentage of the
    world’s children living with HIV/AIDS. From the beginning of the
    epidemic through the end of 2002, 9,300 American children under age 13
    had been reported to the Centers for Disease Control and Prevention
    (CDC) as living with HIV/AIDS. The vast majority of HIV-infected
    children acquire the virus from their mothers before or during birth or
    through breast feeding. Because of the widespread use of AZT and other
    highly active antiretroviral therapy (HAART) in HIV-infected pregnant
    women in the United States, only 92 new cases of pediatric AIDS were
    reported in 2002. More than three times that number are infected with
    HIV but have not yet developed AIDS.

    • The U.S. city with the highest rate of pediatric AIDS through
      2002 was New York City, followed by Miami, FL, and Washington, DC.
    • The disease disproportionately affects children in minority
      groups, especially African Americans. Out of 9,300 cases in children
      under 13 reported to the CDC through December 2002, 59 percent were
      black/non-Hispanic, 23 percent were Hispanic, 17 percent were
      white/non-Hispanic, and less than 1 percent were in other minority

    New anti-HIV drug therapies and promotion of voluntary testing
    continue to positively effect the death rate. CDC reported a drop of 68
    percent from 1998 to 2002 in the estimated number of children who died
    from AIDS.


    Almost all HIV-infected children acquire the
    virus from their mothers before or during birth or through
    breastfeeding. In the United States, approximately 25 percent of
    pregnant HIV-infected women not receiving AZT therapy have passed on the
    virus to their babies. The rate is significantly higher in developing

    Prior to 1985 when screening of the nation’s blood supply for HIV
    began, some children as well as adults were infected through
    transfusions with blood or blood products contaminated with HIV. A small
    number of children also have been infected through sexual or physical
    abuse by HIV-infected adults.


    Most MTCT, estimated to cause
    more than 90 percent of infections worldwide in infants and children,
    probably occurs late in pregnancy or during birth. Although the precise
    mechanisms are unknown, scientists think HIV may be transmitted when
    maternal blood enters the fetal circulation or by mucosal exposure to
    virus during labor and delivery. The role of the placenta in
    maternal-fetal transmission is unclear and the focus of ongoing

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