While the AIDS crisis in Africa means that around 500,000 babies are infected with HIV during birth or breastfeeding every year, a new study by Wellcome Trust researchers shows that a surprisingly large number of untreated adolescents with AIDS have all of the features that would be expected from long-term survivors of infant HIV infection.
Previously, experts believed that only 1-in-10 infected babies would survive to adolescence without treatment. Now, they put the figure as high as 1-in-4 surviving into late childhood or adolescence.
"The findings are quite extraordinary," said the Trust's Dr Liz Corbett. "The phenomenon of long-term survival is poorly recognized and until recently has been almost positively resisted by the international HIV community because of the strongly held assumptions that HIV in late childhood is very unusual, and that survival from birth to adolescence with HIV was so unlikely without treatment as to be negligible. This just doesn't fit with what we see in Zimbabwe and hear from neighboring countries."
But this hardy bunch of HIV positive kids has presented health authorities with a challenging problem. "Because of the previous assumption that HIV-infected infants did not survive to adolescence, no concerted effort has been made to provide diagnostic or treatment programs for this age group," explained Dr Corbett. "They have problems unique to their age-group and circumstances, over and above coping with their own illness. These include a lack of awareness of their own diagnosis, their emerging puberty and sexuality, caring for sick parents and coping with the social and economic consequences of [being] orphaned."
Corbett and others believe that earlier diagnosis is vital to better help infected youngsters in Africa. She says this would allow adolescent-focused support for treatment regimes, specific help with the problems faced by teenagers with HIV (such as short stature and delayed puberty), and support for those undergoing puberty or who are sexually active, such as counseling on prevention of transmission and contraception.
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Source: Wellcome Trust