Symptoms of HIV in Children
Children who are HIV-positive often fail to gain weight or grow normally. As the disease progresses, they may have difficulty walking or delayed mental development. In addition to being susceptible to the same opportunistic infections that adults are, children may have severe forms of common childhood illnesses such as ear infections (otitis media), pneumonia and tonsillitis.
Normally, white blood cells and antibodies attack and destroy foreign organisms that enter your body. This response is coordinated by white blood cells known as CD4 lymphocytes. These lymphocytes are also the main targets of HIV, which attaches to the cells and then enters them. Once inside, the virus inserts its own genetic material into the lymphocytes and uses them to make copies of itself.
When the new copies of the virus break out of the host cells and enter the bloodstream, they search for other cells to attack. In the meantime, the old host cells and some uninfected CD4 cells die from the effects of the virus. The cycle repeats itself again and again. In the process, billions of new HIV particles are produced every day. Eventually, the number of CD4 cells in the body decreases, leading to severe immune deficiency, which means your body can no longer effectively fight off viruses and bacteria that cause disease.
HIV crosses all cultures, national borders and religions. Anyone of any age, race, sex or sexual orientation can be infected, but you’re at greatest risk of HIV/AIDS if you:
- Have unprotected sex with multiple partners. You’re at risk whether you’re heterosexual, homosexual or bisexual. Unprotected sex means having sex without using a new latex or polyurethane condom every time.
- Have unprotected sex with someone who is HIV-positive.
- Have another sexually transmitted disease, such as syphilis, herpes, chlamydia, gonorrhea or bacterial vaginosis.
- Share needles during intravenous drug use.
- Have hemophilia and received blood products between 1977 and April 1985 — the date standard testing for HIV began.
- Received a blood transfusion or blood products before 1985.
- Have fewer copies of a gene called CCL3L1 that helps fight HIV infection.
- Newborns or nursing infants whose mothers tested positive for HIV but did not receive treatment also are at high risk.
When to Seek Medical Advice
If you think you may have been infected with HIV or are at risk of contracting the virus, seek medical counseling as soon as possible. Tests are available that can determine your status. The idea of being tested for HIV infection is frightening for many people, yet a majority of Americans say they would support routine HIV testing for all adults. What’s more, testing itself doesn’t make you HIV-positive or HIV-negative and is important not only for your own health but also to prevent transmission of the virus to others.
You can be tested by your doctor or at a hospital, the public health department, a Planned Parenthood clinic or other public clinics. Many clinics don’t charge for HIV tests. Be sure to choose a place in which you feel comfortable and that offers counseling before and after testing. Don’t let concern about what people may think stop you from being tested. For a referral, or to make an appointment for an HIV test at a Planned Parenthood clinic near you, call 800-230-PLAN, or 800-230-7526. You can also contact your local or state health department.
If you’re pregnant, you may want to get tested even if you think you’re not at risk. If you are HIV-positive, treatment with anti-retroviral drugs during your pregnancy can greatly reduce the chances you’ll pass the infection to your baby. And if you engage in a high-risk behavior such as unprotected sex or sharing needles during intravenous drug use, experts recommend that you get tested for HIV every three to six months.
All states and U.S. territories now report positive HIV and AIDS test results to state public health officials to help track the spread of the disease. Most states use name reporting, but the results are released only to the health department and not to anyone else — including the federal government, employers, insurance companies and family members — without your express permission. In addition, legal provisions ensure the highest degree of confidentiality with regard to name-based HIV data. A few states, including Montana and Oregon, use name-to-code reporting. Don’t let the HIV reporting policy prevent you from seeking testing or treatment. If you are concerned about having your name reported, many states offer anonymous testing centers. If you do test positive and seek treatment, however, you will likely have to provide your name to your doctor.
Screening and Diagnosis
HIV is diagnosed by testing your blood or oral mucus for the presence of antibodies to the virus. The CDC encourages voluntary HIV testing as a routine part of medical care for all adolescents and adults ages 13 to 64, in new recommendations issued in September 2006. Although the CDC says that everyone should be tested at least once, yearly testing is recommended only for people at high risk of infection.
Unfortunately, HIV tests aren’t accurate immediately after infection because it takes time for your body to develop these antibodies — usually about 12 weeks. In rare cases, it can take up to six months for an HIV test to become positive.
For years, the only available test for HIV was the enzyme-linked immunosorbent assay (ELISA) test that looked for antibodies to the virus in a sample of your blood. If this test was positive — meaning you had antibodies to HIV — the same test was repeated. If the repeat test was also positive for HIV antibodies, you’d then have another confirming blood test called the Western blot test, which checks for the presence of HIV proteins. The Western blot test was important because you may have non-HIV antibodies that cause a false-positive result on the ELISA test. Combining the two types of tests helped ensure that the results were accurate, and you’d receive a diagnosis of HIV only if all three tests were positive.
The downside is that it can take up to two weeks to get the results of the ELISA and Western blot tests, a period of time that can take an emotional toll and that discouraged many people from returning to get their test results. Now, however, several “rapid” tests can give highly accurate information within as little as 20 minutes.
These tests look for antibodies to the virus using a sample of your blood or fluids collected on a treated pad that’s rubbed on your upper and lower gums. The oral test is almost as sensitive as the blood test and eliminates the need for drawing blood. A positive reaction on a rapid test requires a confirming blood test. And because the tests are relatively new and were originally approved for use only in certified laboratories, they may not be available in all locations.