Pediatric HIV prevention and treatment of conventional routes

Children for perinatal HIV transmission, communication and adolescent health guardian of opportunistic infections targeted prevention. Treatment can be used antiretroviral drugs, combined therapy, immune therapy treatment. HIV transmission prevention Perinatal against the spread of HIV infection for all pregnant women recommended the use of AZT treatment. A landmark study shows that use of AZT treatment can reduce perinatal transmission of 1 / 3. Its use in 14 to 34 weeks of pregnancy to start treatment, and adhere to the medication throughout pregnancy, childbirth in the use of intravenous injection. Baby after birth to the first 6 weeks medication. Many scholars suggested that antiretroviral treatment with AZT combination, in order to promote the health of pregnant women and further reduce the spread of the risk of HIV infection. Doctors and pregnant women should consider the advantages and disadvantages of the therapy. In general, antiretroviral treatment (two similar objects nucleotide reverse transcriptase inhibitors and protease inhibitor) is now recommended for non-Pregnancy adult HIV infection in the standard treatment. Therefore have to accept a reversal of anti-retroviral therapy program for women, once pregnant, should continue to be treated, but not in the past have treated pregnant women, adults should be non-Pregnancy 2 or 3 kinds of medication. No matter what kind of treatment using AZT is used to be. Safety advocates of the use of milk in other countries, such as the United States, HIV-infected mothers not breast-feeding. HIV infection in the same wet nurse should not be re-offer milk. However, infectious diseases and malnutrition is the cause of early infant death, one of the important reasons for a number of countries, the World Health Organization recommends that no matter how the situation of HIV serum or breast-feeding advocates. Puberty due to the spread of adolescence is a special risk of HIV infection stage, so this group should be health education, HIV serum tests to find out their serostatus. Health education should include the spread of the disease, symptoms, prevention key, for those who are sexually active to carry out acts of high-risk sexual abstinence as well as the security method (right, insist on condom use) guidance. The prevention of this disease should focus on high-risk adolescent HIV infections. Inspection due to the informal agreement, no matter how the situation in the serum should be given to promotional materials. In patients without consent, whether or not divulge their sexual partners of his HIV status secret, according to the following: their partners at risk the possibility of whether the other party has reason to suspect that this may cause and to alert the moral Privacy advocates are still secrets, secrets on the future relationship between the two, and so on, and then make a decision. Health guardian guardian health caused by acupuncture, the average risk of HIV infection is 0.3 percent, but if a lot of virus in patients blood and a large amount of blood, the risk of increased accordingly. Skin and mucous membrane contact with the risk of a very small (less than 0.3 percent). However, every effort should be made to avoid blood or other body fluids contact. Hospital staff should be careful as far as possible, the use of standard precautions. After being exposed to the temporary preventive measures can be found in section 163 of occupational exposure. Day-to-day routine to deal with human milk out of the Administrative Office of the Health and Safety officers do not use gloves. But the milk bank workers to be prolonged exposure to human milk should be wearing gloves. Milk banks should strictly abide by the U.S. Department of Health issued regulations, including milk for all those infected with HIV for the screening will increase the risk of infection in a variety of factors, as well as assessment of all pasteurized milk samples were carried out. The overflow of blood or other tissue fluid, organic ingredients should be first washed, then fresh preparation of bleaching powder (1:10-1:100) disinfection. On the prevention of opportunistic infections The vast majority with significant immunodeficiency patients, the need to pay attention to the prevention of Pneumocystis carinii disease (PCP). There have been PCP patients regardless of their CD4T lymphocyte count, to be life-long chemical drug prevention. For HIV-infected mothers give birth to their babies after birth should be from 4 to 6 weeks to start preventive measures. A series of virus culture and polymerase chain reaction (PCR)-negative children, completely rule out the possibility of HIV infection before the termination of preventive measures. CD4T lymphocytes in the blood count had shown that there are children with immune suppression (CD4 cell count that is lower than 750/μl, or CD4 lymphocytes in the full cycle of less than 15%) preventive measures should continue until after the age of 1 . For sustained CD4T lymphocyte count in those above the threshold, at the age of 1 may be stopped to prevent another. For 1 to 5-year-old HIV-infected children, as long as CD4T lymphocyte count less than 500/μl or CD4 percentage below 15%, CD4T lymphocyte count decreased or severe symptoms of HIV disease, as shown in Table 265-13 C level should be targeted to prevent PCP. In addition to the absolute CD4 count of different ages have different, older children and adolescents is the same as the standard. For children 6 years of age, CD4 count below 200/μl or lower than the percentage of 15% indicate the need for prevention. For adolescents or young adults, if the CD4 cell count below 200/μl or less than 15%, or in patients with fever of unknown origin has reached more than 2 weeks or has a history of oropharyngeal candidiasis, both should carry out prevention. More than 1-year-old HIV-infected children, had never received Pneumocystis cyst disease prevention (that is, before the children are not diagnosed or not to prevent their continued) as long as their CD4 cell count showed that there are severe immune suppression should be Acceptance of preventive measures. For the prevention of PCP in children is a measure of a week in a row on the 3rd to take TMP-SMX (one day TMP150mg/m2, SMX750mg/m2, taking into 2nd) (for example, every Monday, two, three medication), other programs such as weekly 3, the volume of the day taking 1st, 2nd or service every day in a row to take, as well as the medication the next day, and so on. For children over the age of 5 can not tolerate TMP-SMX who pentane microphone can be inhaled aerosol (per month through the inhalation of smoke-300mg), who used intravenous pentane microphone, but the effect is rather poor, and toxicity than other The way to greater prevention. Other programs, especially for children under 5 years of age, such as daily oral 2mg/kg of dapsone (total dose of no more than 100mg) may have. Effective prevention of PCP, including drug dapsone, and pyrimethamine, sulfadoxine and pyrimethamine, as well as oral atropine boast one (atovaquone). But these drugs in adults and children in the application of the experience is limited, it is recommended only if the program can not be implemented or when patients can not be tolerated in order to be considered. On the other opportunistic infections prevention also need to pay attention to. Over the age of 6 on the CD4 <50/μl (or 2 to 6-year-old CD4 <750/μl), the prevention of bird-Mycobacterium tuberculosis co-infection of the week, should be Azithromycin or taking clarithromycin, or change clothes every day Rifabutin. Other opportunistic infections such as cytomegalovirus infection inclusion bodies, fungal disease, toxoplasmosis encephalitis limited information on preventive measures. Treatment Anti-retroviral drug dose, as well as the use of the most important side effects listed in the table of 265-17. The new antiretroviral drugs, vaccines and immune regulator in the evaluation. As the experts on the diagnosis and treatment of the general views and knowledge change very quickly, so in a timely manner to ask the expert care of HIV infection is very important.