Infant Toddler Development Training
Module 6, Lesson 5
Immune Deficiency and HIV
To understand immune deficiency, the ITDS must first understand immunity. Immunity involves cellular and chemical elements. The mark of a healthy immune system is the ability of the body to respond to foreign material through the process of inflammation.
The signs of inflammation are: redness (rubor), heat (calor), pain or tenderness (dolor), swelling (tumor), and functio laesa (loss of function). These inflammatory symptoms are present in the blood vessels or adjacent tissues when a foreign agent is introduced into the body or when an injury to the body has occurred. The process of inflammation is part of a healthy body's natural protection and repair mechanism. In this process, cellular elements, such as white blood cells in the blood stream and tissues, and chemical elements, such as immunoglobulins, work to repair and protect the affected area. Immunoglobulins produce antibodies that are part of the body's natural defense against infection.
Pathophysiology is when the body's natural immune processes are not working properly. The processes may be out of balance and the immune system overreacts (autoimmune) and actually fights its own cells or certain elements are missing or lacking (immune deficiency) and the body cannot fight infection. Immune deficiencies include allergies, cancers, and isolated blood disorders. Many of the conditions are genetic in origin.
Unlike the genetic immune deficiencies, human immunodeficiency virus or HIV infection is an acquired immunodeficiency. Millions of people have been infected with HIV worldwide. There are approximately 1.4 million children infected and about 34 million adults. Perinatal transmission (vertical transmission from mother to baby during the birth process) accounts for 90% of HIV infections in children. The risk of perinatal transmission drops from 25% to 1- 2 % with proper medical care in both the prenatal and postnatal period. Screening of pregnant women is essential.
There are measures that significantly reduce the risk of the baby becoming infected from a mother who has HIV. Pretreatment of both the mother and the baby with a drug known as AZT before and after delivery greatly reduce the risk of infection in the infant. Proper nutrition is of paramount importance to assist in fighting off infection. HIV in children is identified by 1 month of age or excluded by 6 months of age with final confirmation of exclusion by 18 months of age.
Consider interventions that the medical and developmental team are aware of when treating a child with HIV. Remember that the ITDS will be working with doctors, nurses, and social workers.
Consider the most important intervention that all team members must remember when providing care for a child with HIV in order to reduce the risk of infection.
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