Two million children are currently infected with HIV, and an additional 1800 HIV infected infants are born everyday. HIV infection remains an ultimately lethal disease. In developing countries the most common causes of deaths associated with AIDS are tuberculosis, septicemia, pneumonia, meningitis, or toxoplasmosis. Some of these causes of death can be prevented or minimized via close medical follow up of HIV infected children. In Uganda we followed a cohort of 200 HIV infected infants for 10-12 years. In spite of no specific treatment for the HIV virus, many of these children lived relatively symptom free and were able to attend school . As we wait for practical, affordable, and curative interventions against the HIV virus the following low cost interventions can extend the length and quality of life for HIV infected children.
1. Provide infants
and toddlers with excellent and regular well child care including all usual
immunizations.
2. Provide
nutritional supplements to breast feeding mothers.
3. Intervene
immediately if the child shows growth faltering by providing food supplements
to both mothers and children.
4. Provide vitamin A
supplements to all infants.
5. Provide HIV
infected children with daily bactrim or septrim.
6. Monitor
tuberculin skin tests and treat tuberculosis infection promptly.
7. Train families in
how to treat diarrhea with oral rehydration.
8. Treat diseases
such as otitis media, pneumonia, and malaria promptly.
As we wait for Nevirapine to become available to all
HIV infected pregnant women and for inexpensive drug regimens to cure AIDS, it
makes sense to provide every possible low cost intervention to children born to
HIV infected mothers. On the horizon is a filter to remove the HIV virus from
breast milk and research is proceeding with low cost anti retroviral inhibitors
such as chloroquine. Keeping HIV infected children as healthy as possible will
increase the likelihood that they will benefit substantially as the new drug
regimens become available.