HIV/AIDS

HIV/AIDS Overview

AIDS, acquired immunodeficiency syndrome, is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By progressively damaging and reducing the effectiveness of the immune system, HIV interferes with a person's ability to fight off viruses, bacteria, and fungi that cause disease. This leaves people susceptible to certain types of cancers and infections the body would normally resist, such as pneumonia and meningitis. The virus and the infection itself are known as HIV. AIDS is the name given to the later stages of an HIV infection.

Forms of HIV

HIV can be transmitted by sexual contact, through blood, or from mother to child. HIV-1 is the most predominant type of the virus worldwide but there is also a second type, HIV-2. The two types appear to cause clinically indistinguishable AIDS, however HIV-2 is less easily transmitted and the amount of time between initial infection and illness is longer. Generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.

Children Affected

In 2008, 2.1 million children around the world were living with AIDS and an estimated 430,000 of them had been newly infected that year. That same year 2 million people died of AIDS, more than one in seven of them were children.

About 9 out of 10 of the children living with HIV live in Sub-Saharan Africa while other large numbers of children with HIV live in the Caribbean, Latin America, and South/South East Asia. Most of these children were infected through their mothers either during pregnancy, birth, or breastfeeding.

HIV treatment for children slows the progress of HIV infection and allows the infected children to live much longer, healthier lives. A problem for children living with HIV are childhood illnesses like mumps and chickenpox that with a weak immune system become more frequent, last longer, and do not respond as well to treatment. Tuberculosis and PCP are also serious risks for children living with HIV.

Causes of HIV/AIDS

HIV is transmitted when the virus enters the body, usually by injecting infected cells. There are several possible ways in which the virus can enter. Most children with HIV/ AIDS are infected by their mothers who transmit the virus to their babies during pregnancy or birth, when the infected maternal cells enter the baby's circulation. Most often in adults the HIV infection is spread by having sex with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex. HIV is also frequently spread among injection-drug users who share contaminated needles or syringes. Accidental needle sticks or contact with contaminated fluid can spread HIV in a health-care center. Lastly, very rarely, HIV spreads through the transfusion of contaminated blood or blood components The virus does not spread through casual contact such as preparing food, sharing towels and bedding, or via swimming pools, telephones, or toilet seats. The virus is also unlikely to be spread by contact with saliva, unless it is contaminated with blood.

Diagnosis

Most children living with HIV become infected through mother-to-child transmission, and these children need to be tested as soon as possible after birth to find out if they are infected with the virus. If a child living with HIV is only diagnosed once they are ill, it may be too late for antiretroviral treatment to be effective.

In developed countries, children can be tested soon after birth, sometimes within 48 hours, using polymerase chain reaction (PCR) tests and other specialist techniques. In resource-poor countries, where PCR testing is generally unaffordable or unavailable, a mother may have to wait up to 18 months after giving birth before antibody tests, which are used in adults, and are more commonly available, can be used to accurately diagnose her child. However a new form of testing referred to as dried blood spot testing has been implemented in underdeveloped areas. This form of testing involves taking a small sample of blood from the child and dropping it onto a paper to be sent to a laboratory where it can be tested. Without the need to be refrigerated, these samples can be easily transported miles away where PCR is available, allowing children in resource- poor areas to be tested relatively quickly. Unfortunately, dried blood spot testing can be expensive and it can take a long time for test results to return. There's also evidence that when certain drugs are used during pregnancy, dried blood spot testing doesn't always detect HIV in the first few days of the child's life.

Symptoms

Many people with HIV do not know they are infected and do not at first experience symptoms. While the following may be warning signs of HIV infection, it is important to note that you cannot rely on symptoms to know whether or not you are infected and many people who are infected with HIV do not have any symptoms at all for many years. Symptoms include:

A flu-like illness


Fever


Headache


Tiredness


Enlarged lymph nodes in the neck, armpits, or groin


Rapid weight loss


Dry cough


Night Sweats


Diarrhea


Oral Thrush


Pneumonia


Red, brown, pink, or purplish blotches on or under skin, or inside mouth, nose, or eyelids


Pelvic inflammatory disease in women


AIDS is the later stage of HIV infection, when the body begins losing its ability to fight infections. Once the CD4 cell count falls low enough, an infected person is said to have AIDS. Sometimes, the diagnosis of AIDS is made because the person has opportunistic infections that take advantage of the opportunity to infect the weakened host. These infections and conditions include:

Pneumonia caused by Pneumocystis, which causes wheezing


Brain infection with toxoplasmosis which can cause trouble thinking or symptoms that mimic a stroke


Widespread infection with a bacteria called MAC (mycobacterium avium complex)


Yeast infection of esophagus


Widespread diseases with certain fungi like histoplasmosis


Lymphoma in the brain


Cancer of the soft tissues called Kaposi's sarcoma, which causes brown, reddish, or purple spots that develop on the skin or in the mouth.

 


Treatment

Antiretroviral therapy (ART) is the most effective treatment for children with HIV and requires several antiretroviral drugs to be taken each day. The aim of this treatment is to keep the amount of HIV in the body at a low level, stopping the weakening of the immune system and allowing it to recover from any damages that HIV may have already caused. This treatment reduces illness and mortality among children living with HIV in much the same way that it does among adults.

Facts about HIV/AIDS

Globally there were 2.6 million children living with HIV in 2014 and 220,000 new infections among children

32% of all children globally living with HIV were accessing treatment in 2014, compared to just 14% in 2010

Contact CCBF doctors about HIV/AIDS

If you have any questions about HIV/AIDS or want to schedule an appointment, please call 212-746-3400 to schedule a visit.

Visit our Resources section for brochures, latest publications, and upcoming conferences to learn more about HIV/AIDS.

 

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