Guideline for Management of Pediatric HIV/AIDS - Bhutan
(2008; 81 pages)


Pediatric AIDS strikes the population devastated by multiple social stresses. The epidemic further aggravates the socio-economic vulnerabilities of the weakest in the society including women and children. Health care workers must help in clarifying misconceptions and creating awareness for prevention strategies of this disease.

Children born with HIV have very high mortality. They are over four times more likely to die by the age of two than children born without HIV. HIV has contributed to a rise or stagnation in under- five mortality in several countries in Africa, but is not the only factor behind these trends.

The clinical manifestations of HIV infection in children are different from those in adults. The immune system of young children, who are infected perinatally, is immature and hence dissemination throughout the various organs may occur very early. Organs such as the brain may be susceptible to the effects of the virus in a manner different from the observed in adults. Even the pattern of opportunistic infections in children is different from those in adults. Children tend to suffer from primary infection while adults are more likely to suffer from reactivation of infection as their immunity wanes in response to advanced HIV-infection.

Bhutan has recorded increase of HIV infection among the children. So far 13 children are recorded with HIV infection from their mothers. Currently the mother to child transmission constitutes nearly 9% of the total 160 cases.

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