Human Immune Deficiency Virus- Acquire Immune Deficiency Syndrome (HIV-AIDS)

Introduction

A lethal illness is the human immunodeficiency virus infection (HIV), which causes AIDS (Acquired Immune Deficiency Syndrome). Around the world, his illness has afflicted a sizable number of children.

Epidemiology

The HIV1 and HIV2 serotypes of the human immunodeficiency virus are protein-coated RNA viruses of the retrovirus family. Compared to HIV2, HIV1 is more pathogenic. The patient or carriers serve as the infection's reservoir. Once infected, the virus stays in the boy for a very long time. The symptomless carriers can spread the disease to others for extended periods of time because the incubation period may last years. Cerebrospinal fluid, semen, and contaminated blood serve as the infection's primary carriers. Lower concentrations have been found in vaginal secretions, breast milk, saliva, tears, urine, and cervical secretions. The virus has been found in skin, lymph nodes, bone marrow, and brain tissue.

Mode of Transmission

• Adult sexual routé.
• Transfer between parents and children, including vertical transmission from an infected woman to a fetus or from a mother to a child, is a serious concern. Transmission can happen in the uterus, during delivery, and even during nursing.
• Transfusion of blood and blood products
• Transplantation of organs
• Prick of a contaminated needle
• Using contaminated tools during surgery or any skin-piercing tool during ear piercing, tattooing, acupuncture, or circumcision.

Clinical Features

Low birth weight, growth failure, microcephaly, hepatosplenomegaly, lymphadenopathy, pneumonia, recurrent otitis media, oral thrush, chronic diarrhea, chronic parotid swelling, unexplained anemia, thrombocytopenia, weight loss, night sweats, and recurrent pyrexia are all common in infants born to mothers who have HIV infections.

Major criteria:

• Loss of weight or unusually slow growth
• Diarrheal illness for more than a month
• Persistent or sporadic pyrexia for more than a month

Minor criteria:

• A widespread lymphadenopathy
• Candidiasis of the oropharynx
• Recurring infections with common germs
• A prolonged cough lasting more than a month.
• A widespread dermatitis
• HIV infection in the mother has been confirmed.

Diagnosis

• History study.
• Laboratory tests include:
  • ELISA (Enzyme Immuno-Absorbent Assay) assays, screening tests for anti-HIV, and IgG detection are examples of laboratory tests.
  • Confirmatory tests are carried out using Western blots.
  • CD4 cell number
  • T cell density and T cell development elements
  • HIV testing using antigens and culture
  • Total count, differential cell count, and platelets in hematology

Management

Once the illness has taken hold, there is no cure for HIV/AIDS. The essential components of managements are preventative actions. Therefore, it is important to protect children from adult-to-child transmission of the HIV virus. If the child contracts the infection, rapid diagnosis and treatment should be started. The following are components of supportive management for a child with HIV/AIDS:

• Nutritional assistance.
• Treatment for discomfort, fever, cough, and diarrhoea.
• Opportunistic infection control.
• Social support and family therapy.

When a youngster signs of immunological depression or other accompanying symptoms, specialized antiretroviral medication is administered. Children frequently take medications including zalcitabine, didanosine, and zidovudine.

Preventive Measures

Health education should be given. Health education includes:

• Avoiding risk elements
• Achieve life-saving decisions.
  • Post-exposure prophylaxis or antiretroviral therapy in combination. Avoiding adult discrimination in sexual behavior and using condoms can prevent parent to child transmission.
• Proper blood and blood product screening, as well as avoiding commercial blood donation
• Instead of using a glass syringe and needle for injections and vaccinations, use a disposable one.
• Use sterile procedures when giving birth and having surgery.
  • Caution when being around bodily fluids.
  • Drive to refrain from using IV drugs and having hazardous sex
• Giving prophylactic doses of zidovudine to infants and pregnant patients with the infection for the first six weeks of life to stop vertical transmission.
• Antiretroviral medications can be combined with post-exposure prophylaxis for 4 weeks immediately following unintentional exposures to the virus through needlestick wounds.

Roles of nurse in reducing less than five mortality and morbidity in fewer than five children.

Twelve essential household practices for newborns and infants that can support community efforts to improve child survival, health, and nutrition have been agreed upon by a number of organizations, including UNICEF and WHO. Additionally, this can lower child mortality and morbidity:

• Exclusive breastfeeding: exclusively breastfed for the first six months after birth. (Mothers who are HIV-positive must receive counseling about potential breastfeeding substitutes.)
• Complementary feeding: More than 10% of deaths from diarrhea and acute respiratory infections, particularly pneumonia, could be avoided by starting complementary feedings at around six months of age, continuing breastfeeding for at least two years, and increasing a child's resistance to measles and other illnesses.
• Micronutrient supplementation: The mortality rate for children between the ages of six months and five could be cut in half by increasing the intake of vitamin A through diet or supplements in areas where it is deficient.
• Hygiene: The incidence of diarrhea could be reduced by 35% with better hygiene habits, including hand washing with soap (or ashes) and proper excreta disposal.
  Immunization: The majority of measles-related deaths each year may be avoided if infants under the age of one received the measles vaccine. Before turning one, parents and caregivers should ensure that children have received the full course of immunizations (measles vaccine, diphtheria, pertussis, and tetanus vaccine, bacilli Calmette-Guérin, and diphtheria, pertussis, and tetanus vaccine).
• Malaria prevention: Insecticide-treated mosquito nets could reduce child deaths from malaria by up to 23% in homes in malaria-endemic regions.
• Psychosocial care and development: Encourage a child's mental and social development by attending to their needs, talking to them, playing with them, and creating an environment that is stimulating.
• Feeding and fluids for sick children: When children are ill, keep feeding them and give them more fluids, including breast milk.
• Home treatment: Give ill children the proper at-home antibiotics for their infections.
  Seeking care: Recognize when sick children require care outside the home and contact the proper medical professionals.
• Appropriate practices: Follow the health worker’s advice about treatment, follow-up, and referral.
• Antenatal care: Every expectant woman needs to get quality antenatal care. This involves receiving the recommended doses of tetanus toxoid immunization and attending at least four prenatal appointments with a qualified healthcare professional. The mother also requires assistance from her family and community when she seeks medical attention during childbirth, the postpartum period, and while she is nursing.

Providing proper care for persons impacted by HIV and AIDS, especially orphans and vulnerable children, protecting children from harm and accident, abuse and neglect, and including dads in the care of their children are additional crucial practices that safeguard children.

Given the proper assistance and distribution of goods and services, many of these procedures can be carried out by community health professionals or even by members of the community themselves. The community should be directly involved in the parts of nutrition and healthcare that have the biggest daily impacts on its members. These include other caring actions, water and sanitation, and feeding infants and young children.

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