HIV-EXPOSED UNINFECTED CHILDREN - BY: GODDAY OJORE AGHEDO

The increasing success of the prevention of mother to child transmission (PMTCT) of HIV is a clear indication that HIV-exposed uninfected (HEU) children have continued to abound in number. HEU children simply refer to those babies born to HIV positive mothers, but who are uninfected with the virus or who turned out to be HIV negative. The evidence for health problems among HEU children, the causes of such problems and the possible solution or control measures, form the focus of this article.

One of the most emotive and tragic dimension of the HIV epidemic is the HIV infection of infants through mother to child transmission (MTCT). As a consequence, health challenges of HEU infants should be of enormous public health significance; but unfortunately, there appears to be limited available information on this subject matter. Most available reports are those obtained from developed and industrialized countries. But in Africa where many countries are either underdeveloped or developing, poor diets or malnutrition, exposure to malaria and other infections, parental drug abuse, stressful home condition/environment and poverty are prevalent. These are in themselves, are serious threats to the health of HEU infants. If these threats are not professionally addressed in good times, it may lead to the death of HEU infants, which is an undesirable result of PMTCT.

In developed countries MTCT has drastically reduced to a negligible level through a combination of highly active antiretroviral therapy (HAART), elective caesarean section and complete avoidance of breastfeeding. However, in Africa, world health organisation (WHO) advocates exclusive breastfeeding for a minimum of six months; since replacement feeding are very expensive and may be out of the purchasing reach of many HIV infected mothers. Breastfeeding affects the growth, immune system development as well as exposure to HIV in no small measures.

Bye and large, the health problems with HEU children include but not limited to maternal death and low maternal CD4 count, low birth weight (LBW), severe maternal and child anaemia, poverty, single parenting, pneumonia caused by pneumocystis jiroveci and poor cognitive and motor development in the children. On the other hand, lack of parental care, bad infant feeding practices, immune abnormalities, exposure to other infections and even exposure to ARV (especially Zidovudine containing regimen) are potential causes of poor health and nutrition in HEU children.

In conclusion, HEU children and their mothers especially, should be given adequate relevant psychosocial supports. Medical supports like: improving maternal health, providing ART, iron-folate and other micronutrient supplements, prophylactic antibodies against opportunistic infections; as well as socioeconomic supports, are earnestly needed in order to efficiently tackle the health problems confronting the HEU children. Just the same way, HIV-infected infants are given all necessary attention to foster their survival, requisite attention should be directed to HEU children too, since they represent the success of the PMTCT efforts. Consequently, mortality and morbidity among HEU children can be reduced to a minimal level; although it is on record that mortality among HEU children is higher than in HIV unexposed babies.

BY:

GODDAY OJORE AGHEDO