Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


HIV in late childhood and adolescence a growing problem

Scientists have highlighted for the first time the plight of the growing number of older children and adolescents living with undiagnosed HIV and AIDS in Africa. In a study published today in Clinical Infectious Diseases, Wellcome Trust researchers claim that delay in recognising this problem means that the needs of this important group are not being met.

It is estimated that half a million babies were infected with HIV during birth or breastfeeding in 2006, passed down from their mothers. It was assumed that their chances of survival to adulthood were negligible. However, a new study, carried out by researchers based at the Connaught Clinic in Harare, Zimbabwe, shows that older children and adolescent with AIDS have all of the features that would be expected from long-term survivors of infant HIV infection.

“The findings are quite extraordinary,” says Dr Liz Corbett, a Wellcome Trust Senior Clinical Fellow in Tropical Medicine from the London School of Hygiene and Tropical Medicine, based in Zimbabwe. “The phenomenon of long-term survival is poorly recognised 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 neighbouring counties.

"It is now being realised that these earlier assumptions were wrong and that instead somewhere around 1 in 10 infected infants – and perhaps even as high as 1 in 4 – may survive into late childhood or early adolescence without diagnosis or treatment.”

However, late diagnosis is likely to have a significant effect on their future health and long term survival, warn the researchers.

“Early diagnosis of HIV is very important,” says Dr Rashida Ferrand, a Wellcome Trust Research Training Fellow. “A delayed diagnosis means that patients have a much higher risk of developing serious opportunistic infections and may have significant and irreversible damage to vital organs such as heart and lung as well as a higher risk of death. We also know that antiretroviral therapies (ART) are less effective if started in patients with advanced disease.”

Dr Ferrand and Dr Corbett argue that there is a need for more services aimed at older children and adolescents to provide accessible and sympathetic HIV testing and treatment services, counselling and support, and drug formulations for low-weight individuals whose growth may have been stunted by undiagnosed HIV.

“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 programmes for this age-group, despite an epidemic that is becoming increasingly obvious to anyone providing routine medical care in Southern or East Africa,” says Dr Corbett.

It is important to recognise that these children may have already suffered terribly from the indirect effects of HIV, such as orphanhood, impoverishment and the psychological trauma of prolonged illness in parents and siblings, argues Dr Ferrand.

“Simply caring for these patients in existing services is not ideal because they have problems unique to their age-group and circumstances, over and above coping with their own illness,” she says. “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 orphanhood. Hence, provision of effective HIV care and treatment will require additional support and special services to deal with these problems.”

The researchers believe that adolescents would benefit from earlier diagnosis of HIV status, help to parents or guardians who may be reluctant to tell the child what their problem is; adolescent-focused support to ensure adherence to treatment regimes; a focus on the chronic problems associated with HIV (such as short stature and delayed puberty) and the complications of antiretroviral therapy; and support for those undergoing puberty or who are sexually active, such as counselling on prevention of transmission and contraception, and disclosure to sexual partners.

Craig Brierley | alfa
Further information:

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Space observation with radar to secure Germany's space infrastructure

Satellites in near-Earth orbit are at risk due to the steady increase in space debris. But their mission in the areas of telecommunications, navigation or weather forecasts is essential for society. Fraunhofer FHR therefore develops radar-based systems which allow the detection, tracking and cataloging of even the smallest particles of debris. Satellite operators who have access to our data are in a better position to plan evasive maneuvers and prevent destructive collisions. From April, 25-29 2018, Fraunhofer FHR and its partners will exhibit the complementary radar systems TIRA and GESTRA as well as the latest radar techniques for space observation across three stands at the ILA Berlin.

The "traffic situation" in space is very tense: the Earth is currently being orbited not only by countless satellites but also by a large volume of space...

Im Focus: Researchers Discover New Anti-Cancer Protein

An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.

The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

New solar solutions for sustainable buildings and cities

23.03.2018 | Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

Latest News

For graphite pellets, just add elbow grease

23.03.2018 | Materials Sciences

Unique communication strategy discovered in stem cell pathway controlling plant growth

23.03.2018 | Agricultural and Forestry Science

Sharpening the X-ray view of the nanocosm

23.03.2018 | Physics and Astronomy

Science & Research
Overview of more VideoLinks >>>