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Children with HIV
Worldwide, over 3 million children have HIV infection and half a million die every year. Altogether, 83% of children with HIV will show some kind of abnormality in their white cells, or will have symptoms, by the time they are six months old. Problems seen can include large lymph nodes, enlarged liver and spleen, failure to thrive (small for age), small head, ear infections, chest infections, unexplained fever, encephalopathy (brain deterioration).
Of those showing symptoms within the first year of life, half die before the age of three. However, with improved treatments children are surviving longer. A common pattern is beginning to emerge of a child who becomes unwell in the first year or two of life with different chronic or acute infections, yet with treatment carries on for many years, possibly even into adolescence with many ups and downs. Pain and other symptoms are often overlooked in these children.
Blood tests are often confused by the presence after birth of the mother's own antibodies.
All babies of infected mothers will test positive for around the first year, whether infected or not. Most babies who test positive at birth turn out to be uninfected. The greatest risk to the baby is the birth process itself and breast milk. Dramatic reductions in infection rates can be made if the mother is given anti-viral medication before and immediately after birth. This is one of the most appropriate occasions to use anti-viral drugs in the poorest nations. But it should always be done under strict medical supervision.
There is a very slight risk that children who later test negative may still carry HIV. If first infected in the womb, the child may regard HIV as part of itself and not react to it. We are still in the early stages of learning about HIV in children.