Late diagnosis of HIV in children and adolescents born to mothers with HIV in São Paulo (ESP), Brazil
M. Henrique da Silva1, L.H. Matida2, C.S.B. Domingues2, R. Alencar2, M.C. Gianna2
1CRT DST/AIDS - Programme State São Paulo, Day Hospital, São Paulo, Brazil, 2CRT DST/AIDS - Programme State São Paulo, São Paulo, Brazil
Background: Despite advances in the elimination of mother-to-child transmission of HIV (MTCT-HIV) in ESP, 81 cases of AIDS were reported in individuals with 13 to 19 years of age, by MTCT-HIV from 1981 to 2009.
Methods: A retrospective study of seven registered cases of AIDS by MTCT in the period 2008 to 2009.
Results: Average age: 14 years (13-17years), median CD4: 311 (21 to 1367 cells/mm³), 4/7 had CD4 less than 200; all patients were symptomatic at diagnosis, 6 had recurrent infections (sinusitis, pneumonitis), 4 with chronic diarrhea, 3 with oral candidiasis, 2 with herpes zoster , 1 with pneumocystosis, 1 with pulmonary tuberculosis, 28% were submitted to HIV test because their relatives were people living with HIV/AIDS (PLWA) and 72% were aids-defining cases.
Conclusions: The occurrence of late diagnosis of AIDS cases by MTCT is a serious public health problem despite the availability of access to different interventions of this disease. The State Program of STD/AIDS in Sao Paulo recommends:
1) offer HIV testing to all children, regardless of age, of PLWA;
2) offer HIV testing in children and adolescents who present situations, such as: difficulty gaining weight, difficulty in the growth curve, delayed mental development, serious ear infections, pneumonia and tonsillitis, opportunistic infections or with repetitions;
3) to implement assistance of prenatal care offered to pregnant women with HIV, providing effective information about the importance of baby follow-up, remembering the necessity of monitoring in specialized services, at least for two years, for those children diagnosed as uninfected, and permanently for those infected.
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