Pediatric HIV: Australian perspective.
Pediatric infection with human immunodeficiency virus (HIV) in Australia, as elsewhere, now reflects HIV seroprevalence in women of childbearing age although numbers remain small. A perinatal transmission rate of approximately 30% has been observed. The rate appears to be higher for breast-fed babies; exclusively bottle-fed babies of HIV-infected mothers appear to have a risk of < 20% of acquiring HIV perinatally. Although the seroprevalence rate in women of childbearing age in Australia remains low, routine antenatal screening will not be cost-effective. Although passively acquired maternal antibody may confound serodiagnosis for up to 18 months, in practice, HIV infection, when present, can be detected clinically or with use of other laboratory parameters (p24, polymerase chain reaction, viral culture, hyperglobulinemia) during the first 6 months of life. Zidovudine appears to be relatively nontoxic in children and effective in producing weight gain and preventing opportunistic infection. Although experience with didanosine is limited, this drug appears to have a very acceptable toxicity profile and the advantage of twice-daily dosing. However, the bioavailability and penetration into the cerebrospinal fluid are poor. Neurological disease can improve when absorption is adequate. Residential family camps may help to reduce isolation for families and provide them with an opportunity for improving their understanding of HIV through interaction with peers and professionals.
Ziegler
J B
JB
Paediatric AIDS Unit, Prince of Wales Children's Hospital, Randwick, Australia.
Palasanthiran
P
P
Cruickshank
M
M
Langdon
P
P
D000328:Adult; D001315:Australia / Q000453:epidemiology; D016049:Didanosine / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012944:Social Support
D016049:Didanosine