Friesen H
Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Boroko, Papua New Guinea.
P N G Med J. 1996 Sep;39(3):183-9.
HIV infection in children is a family disease, with social, economic and medical aspects that make it one of the most challenging diseases of our time. Knowledge about the factors involved in mother-to-child transmission and the natural history of the disease is gradually increasing although there is still much to understand. As the majority of children become infected through mother-to-child transmission, perinatally acquired infection will parallel increases in heterosexual transmission and the numbers of infected women of childbearing age. Current estimates of the rate of vertical transmission range from 14% to 39% in different studies. The relative proportion of transmission occurring in utero, peripartum or postpartum may vary in different localities and remains unclear. A study recently carried out in the USA showed that zidovudine given late in pregnancy, peripartum and in the neonatal period decreases HIV transmission from 25% to 8%. The clinical presentation of HIV infection in children depends in part on exposure to different infections. In developing countries the children usually present with nonspecific signs and symptoms, such as failure to thrive, chronic diarrhoea, cough and recurrent bacterial infections. Other common presentations include generalized lymphadenopathy, oropharyngeal candidiasis, dermatitis, enlargement of parotid glands and neurological problems, including delayed development.
儿童感染艾滋病毒是一种涉及家庭的疾病，其社会、经济和医学层面使其成为我们这个时代最具挑战性的疾病之一。尽管仍有许多有待了解之处，但关于母婴传播所涉及的因素以及该疾病自然史的知识正在逐渐增加。由于大多数儿童是通过母婴传播而感染，围产期获得性感染将随着异性传播以及育龄感染妇女数量的增加而相应上升。不同研究中目前对垂直传播率的估计在14%至39%之间。在子宫内、围产期或产后发生传播的相对比例在不同地区可能有所不同，目前仍不清楚。美国最近开展的一项研究表明，在妊娠晚期、围产期和新生儿期给予齐多夫定可使艾滋病毒传播率从25%降至8%。儿童艾滋病毒感染的临床表现部分取决于接触不同感染的情况。在发展中国家，儿童通常表现为非特异性体征和症状，如发育不良、慢性腹泻、咳嗽和反复细菌感染。其他常见表现包括全身淋巴结肿大、口腔念珠菌病、皮炎、腮腺肿大以及神经问题，包括发育迟缓。
