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Acquired Immune Deficiency Syndrome (AIDS) / Human Immunodeficiency Virus (HIV)

What is HIV?

Human immunodeficiency virus (HIV) is the virus that is responsible for causing acquired immune deficiency syndrome (AIDS). The virus destroys or impairs cells of the immune system and progressively destroys the body's ability to fight infections and certain cancers. In adults and adolescents, HIV is most commonly spread by sexual contact with an infected partner. In the US, nearly all HIV infections in children under the age of 13 are from vertical transmission, which means the virus is passed to the child when they are in their mother's womb or as they pass through the birth canal. The virus has also been detected in breast milk. Before 1985, a small group of children were infected with the virus by contaminated blood products. Routine screening of blood products began in 1985. Not every child born to an HIV-infected mother will acquire the virus.

How is HIV transmitted or spread?

The following are the means by which the HIV virus is spread:

No known cases of HIV/AIDS have been spread by the following:

What are the symptoms of HIV?

The symptoms vary depending on the age of the child. The following are the most common symptoms of HIV infection. However, each infant, child, or adolescent may experience symptoms differently. Symptoms may include:

Mild Moderate Severe
Swollen lymph nodes Pneumonitis - swelling of lung tissue Two serious bacterial infections in a 2 year period (meningitis, blood infection, or pneumonia)
Swelling of the parotid gland (salivary glands located in front of the ear) Oral thrush that lasts for more than 2 months (a fungal infection in the mouth that is characterized by white patches on the cheeks and tongue. These lesions may be painful to the child.) A yeast infection that occurs in the digestive track or lungs
Constant or recurring sinus infections Constant or recurring diarrhea Encephalopathy - a deterioration of the brain
Constant or recurring ear infections A fever that persists for more than one month Tumors or malignant lesions
Dermatitis - an itchy, rash on the skin Hepatitis - an inflammation of the liver that is often caused by an infection PCP or Pneumocystis carinii pneumonia (the type of pneumonia most commonly seen with HIV)
Abdominal swelling from increased liver and spleen size Complicated chickenpox
Kidney disease

Persistent or severe symptoms may not surface for 10 years or more, after HIV infection first enters the body in teens and adults. This "asymptomatic" period of the infection is highly variable from person to person. But, during the asymptomatic period, HIV is actively infecting and killing cells of the immune system. Its most obvious effect is a decline in the blood levels of CD4+ cells (also called T4 cells) - the immune system's key infection fighters. The virus initially disables or destroys these cells without causing symptoms.

An HIV-infected child is usually diagnosed with AIDS when the immune system becomes severely damaged or other types of infections occur. As the immune system deteriorates, complications begin to develop. The following are some common complications, or symptoms, of AIDS. However, each child may experience symptoms differently. Symptoms may include:

Some people develop frequent and severe herpes infections that cause mouth, genital, or anal sores, or a reactivation of chickenpox known as shingles.

The symptoms of an HIV infection may resemble other medical conditions. Always consult your child's physician for a diagnosis.

How is HIV diagnosed?

Diagnosis of HIV infection during infancy depends on the detection of the virus. Since all infants born to HIV-infected mothers have a positive antibody test at birth because of the passive transfer of the HIV antibody across the placenta, virological testing is used to confirm the diagnosis.

For infants born to HIV-infected mothers, viral diagnostic testing is usually performed within the first 2 days of life, at 1 to 2 months of age, and at 4 to 6 months of age. A diagnosis of HIV infection can be made with two positive virologic tests obtained from different blood samples.

For children over 18 months, adolescents, or adults, diagnosis is made by testing the blood for the presence of HIV antibody.

Children with HIV and routine immunizations:

Always consult with your child's physician regarding immunizations for an HIV-infected child.

Treatment for HIV:

As with many other conditions, early detection offers more options for treatment. Today, there are medical treatments that can slow down the rate at which HIV weakens the immune system, but, currently, there is no cure for the disease. However, there are other treatments that can prevent or cure the conditions associated with HIV. Anti-retroviral drug therapy may be given to a pregnant woman, which has proven to greatly reduce the chance of an infant developing HIV. A cesarean section may be recommended to reduce infant transmission from the birth canal. In the US, where other feeding options are available, an infected mother should be discouraged from breastfeeding her infant. Consult your child's physician for more information regarding various drug therapies.

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Online Resources of Infectious Diseases

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