Author/Editor		Čižman, Milan; Arnež, Maja; Pokorn, Marko
Title		HIV-okužba v otroški dobi
Translated title		HIV infection in childhood
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 36, št. Suppl
Publication year		1997
Volume		str. 99-119
Language		slo
Abstract		According to the World Health Organization estimate there are 22,6 milion people infected with HIV. Eighty percent of infected women and children live in the Subsaharan Africa and children comprise 15 to 20 percent of all AIDS cases. In developed countries children with AIDS represent less than 2 percent of all AIDS cases. The most common route of HIV infection in children is vertical transmission from mother to her offspring. The risk of vertical HIV transmission is estimated to be between 13 and 20 percent in Europe, between 25 and 30 percent in Africa and between 16 and 39 percent in the United States. In children infected in utero signs of HIV embriopathy can be present. If children are infected around birth, they present with non-specific clinical symptoms and signs. Children infected affer birth can present with acute retroviral syndrome. HIV infection is diagnosed on the basis of epidemiological data, clinical picture, immunological and virological tests. HIV affects immune system and T cell immunity is most severely affected. With disease progression the number of CD4 cells decreases and therefore CD4 counts can be used to assess disease progression. Children infected with HIV are classified according to clinical presentation and immunological criteria. Early diagnosis as well as prompt institution of therapy, prophylaxis and supportive treatment are essential for improved outcome. Treatment of children with AIDS includes antiretroviral therapy, therapy of viral, bacterial, parasitic and fungal infections, treatment of malignant disease and supportive treatment.
Summary		Svetovna zdravstvena organizacija ocenjuje, da je na svetu s HIV okuženih 22,6 milijonov ljudi. Osemdeset odstotkov okuženih žensk in otrok živi v subsaharski Afriki, kjer otroci predstavljajo 15-20 % vseh primerov aidsa. V razvitih državah je delež otrok pod 2%. Pri otrocih je vertikalni prenos, to je z matere na otroka, najpogostejši način okužbe. Ocenjujejo, da je v Evropi tveganje za prenos med 13 in 20 %, v Afriki med 25 in 30 % in v ZDA med 16 in 39 %. Otroci, okuženi intrauterino, se lahko rodijo z znaki HIV-embriopatije. Otroci, okuženi perinatalno, imajo neznačilne klinične simptome in znake. Otroci, ki se okužijo z virusom po rojstvu, imajo lahko akutni retrovirusni sindrom. Diagnozo HIV-okužbe postavimo na osnovi epidemioloških podatkov, klinične slike, imunoloških testov in posebnih viroloških preiskav. HIV prizadene imunski sistem, najbolj pa je okrnjena T celična imunost. Z napredovanjem bolezni pade število CD4- celic, kar uporabljamo tudi kot označevalec za napredovanje bolezni. Otroke s HIV-okužbo razvrstimo v skupine na osnovi kliničnih znakov in imunoloških kriterijev. Za izboljšanje napoveda poteka bolezni je potrebna zgodnja diagnoza, zgodnje zdravljenje, profilaksa in podporno zdravljenje. Zdravljenje vključuje protivirusno zdravljenje, zdravljenje bakterijskih, virusnih, zajedalskih in glivičnih okužb, malignih bolezni ter podporno zdravljenje.
Descriptors		HIV INFECTIONS ACQUIRED IMMUNODEFICIENCY SYNDROME CHILD CHILD, PRESCHOOL PROGNOSIS OPPORTUNISTIC INFECTIONS