Special issues and management of hiv exposed uninfected infants and children

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Special Issues and Management of HIV Exposed Uninfected Infants and Children

Amy L. Slogrove¹, Mark F Cotton².

¹Division of Paediatric Infectious Diseases,Department of Paediatrics & Child Health, Faculty of Medicine & Health Sciences, Stellenbosch University, South Africa,
²Family Clinical Research Unit (FAM-CRU), Stellenbosch University, South Africa.

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Abstract
New vertical HIV infections are declining and the numbers of HIV exposed but uninfected (HEU) infants and children are increasing. This positive trend is tempered by the realization that despite escaping HIV infection, the substantial population of HEU children bear consequences of being born to an HIV-infected mother. A structured approach to the care of these children may improve their long term health and well-being. We propose and discuss a 10-point care package for HEU infants centered on providing optimal basic child health management for all children both HIV-exposed and unexposed. Providing basic comprehensive child care interventions benefits all infants, both HIV-exposed and unexposed. For HEU infants, particular attention should be given to providing optimal vertical transmission prevention interventions and conducting appropriate HIV testing. Clinicians should be aware of the consequences of anti-retroviral (ARV) and HIV exposure on HEU infants. As vertical transmission prevention programs become more sophisticated there is a pressing need for the establishment of pharmacovigilance and long-term surveillance systems as well as affordable infant HIV diagnostic tests.

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