LABORATORY EVALUATION TEST FOR HIV INFECTION

LABORATORY EVALUATION /TEST FOR HIV INFECTION IN INFANTS AND TREATMENT
HIV culture and Polymerase Chain Reaction(PCR) are the preferred laboratory test for diagnosing HIV infection in infants. Recommendations for testing infants for HIV includes:
HIV culture or PCR should be performed three times: once at 4 days, once at 1 month of age and once at 4 months of age. If the result of any test is positive, testing should be repeated to confirm the diagnosis of HIV infection.
The diagnosis to rule out HIV infection in infants is based on two or more negative viral diagnostic tests (HIV culture or PCR), both of which are performed at 1 month of age and one which is performed at 4 months of age.
For clinical centres that do not have access to the viral diagnostic tests such as HIV culture and PCR, HIV infection can be ruled out based on two or more negative HIV antibody tests performed at 6 months of age. 
Treatment includes:
Antiretroviral Therapy(ART) -  Any child with a confirmed diagnosis of HIV infection should be evaluated for treatment with ART. For optimal patient care, the primary care provider should decide when to start ART in collaboration with physicians researchers knowledge in the management of pediatric HIV infection. The decision to start ART in children is based on CD4 lymphocyte counts and percentages, viral load and clinical criteria. It's indicated for children who have laboratory evidence or significant immunodeficiency or who have developed any AIDS defining disease manifestations or clinical conditions indicative of immunosuppresion. Zidovudine(AZT), didanosine(ddi), zalcitabine(ddc) and lamivudine(3TC) are only approved antiretroviral agents for use in children.  Two protease inhibitors are now approved for use -noravir and viracept.
Nevirapine - Nevirapine is a nonnucleoside reverse transcrptase inhibitor that has a high degree of antiretroviral activity with minimal toxicity.
Dencyvillah Barasa

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