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===transmission===
→HIV in children
**22,828 infants
===transmission===
*95% mother to child transmission (MTCT)
**intrauterin 6-7%
**prepartum 19%
**postnatal/breastfeeding 10%
**35% risk in total
**risk factor of MTCT
***high VL, low CD4, subtype C HIV 1, cracked nipples, prematurity, ...
*sexual abuse
*sex in adolescent
*blood transfusion
*cultural actions; scarification, circumcision, tattoos by unsteriled knives
===clinical features===
*no symptoms at birth
*no specific symptoms after birth:
**chronic or recurrent diarrhea
**pneumonia (PCP)
**oral thrush
**poor growth
**recurrent severe infection
**chronic parotitis
**bacterial infections
===diagnosis===
*very difficult because of passive maternal antibody up to 18 months of age
*HIV DNA, HIV RNA, P24 antigen
*2 positive virology test means definitive HIV infection
*1 positive virology test means presumed HIV infection
*in the absence of virology test result, based on clinical conditions
*should be confirmed by antibody test after 18 months of age
*refer diagnostic algorithm in the handout
===treatment===
===prevention===
