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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
close this folderCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
View the document7.1 Introduction
View the document7.2 HIV/AIDS Manifestations in Children
View the document7.3 Diagnosis of HIV infection in infants
View the document7.4 Management of infants born to HIV positive women
View the document7.5Care of HIV infected Children
Open this folder and view contents7.6 Clinical manifestations of paediatric HIV infection
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

7.3 Diagnosis of HIV infection in infants

Laboratory tests providing suggestive and/or confirmatory evidence of HIV infection are of two types:

Antibody tests include HIV ELISA and rapid test

Virological tests include HIV DNA PCR assays, RNA assays, and viral culture

The child of an HIV infected mother acquires HIV antibodies from her during pregnancy and these may persist in the blood until 15-18 months of age. A child may thus test HIV positive using antibody tests (ELISA and Rapid tests) without actually being infected. Such a child is termed as HIV exposed. A test must be repeated after 18 months of age to confirm diagnosis.

HIV PCR tests are the preferred virologic method for diagnosing HIV infection during infancy... Where available, if the child is not breastfeeding, PCR test should be performed at the second MCH visit (eight weeks post delivery). If the child is being breastfed a negative virologic test does not exclude infection because the risk of HIV transmission continues throughout the duration of breastfeeding. In such an infant, once breastfeeding has ceased for at least 6 weeks and if the child is over 18 months of age an HIV antibody test can be used to make a diagnosis of infection.

The basic effect of HIV on the immune system is CD4 cell depletion and dysfunction. In children the CD4 percent is the preferred immunologic marker for monitoring disease progression. The immunologic classification for HIV-infected infants and children is shown in table 7.2.

When a child is diagnosed as HIV-Positive or with clinical symptoms, it is strongly recommended to counsel parents/guardians to test other siblings and the parents themselves.

Table 10: Immune Categories by CD4 Count and CD4%

 

Age

Age

Age

Immunologic Category

< 1 Year

1 - 5 Years

6 - 12 Years

Category I No evidence of suppression

> 1500 cells
> 25%

> 1000 cells
> 25%

>500 cells
> 25%

Category II Moderate suppression

750 - 1499
15 - 24%

500 - 999
15 - 24%

200 - 499
15 - 24%

Category III Severe suppression

< 750 cells
< 15%

< 500 cells
<15%

< 200 cells
<15%

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