Diagnosis of HIV infection in children born to HIV-infected mothers is complicated by the fact that in the blood of such children maternal antibodies up to HIV persist for three hours. As of today it has been divided effective methods prevention of vertical transmission of HIV: antiretroviral therapy (ART), which is carried out in the mother during pregnancy and in the bed and in the child in early life; obstetric care, including planned cesarean surgery; Vidmova view breast support. Where these methods are available and established, the frequency of transmission of HIV from mothers to children can be reduced to 1–2%. Remnants of maternal antibodies are retained in the blood of newborn children for three hours; the amount of antibodies allows the diagnosis of HIV infection to be made in children as young as 15–18 months of age. confirmed results using the IB method.
The problem of early diagnosis of HIV infection in newborn children behind the border has become increasingly serious due to the advent of molecular biological methods that allow the detection of fragments of the HIV genome in the blood early terms Infection. It was shown that in most infected children DNA for the VIL provirus can be detected before the first month of life and in almost all of them until the sixth month.
Indications before the completion of various laboratory tests and specific interpretation of the results. For early diagnosis of HIV infection in children born from HIV-infected mothers, it is important to detect HIV provirus DNA in blood cells. It is not recommended to detect HIV RNA, since ART is preventive, which is carried out during the mother's pregnancy and after childbirth, can significantly reduce the replication of the virus, leading to a decrease in The concentration of VIL RNA helps to improve the likelihood of preventing a milk-negative result in a fasted baby. To assign DNA to the VIL provirus, methods are used that rely on ANC (in most cases, PLR).
A child born from an HIV-infected mother must be tested in order to detect DNA for the HIV provirus:
A positive result of the detection of DNA for the VIL provirus is due to confirmation, for re-analysis of the trace, a further sample of blood is taken from a later sample, compared with the anterior sample.
The identification of positive results for the detection of HIV DNA in two blood samples taken from a child older than one month provides laboratory confirmation of the diagnosis of HIV infection.
The elimination of two negative results of DNA testing for the HIV provirus in a child aged 4–6 months (subject to breastfeeding) can be used to prevent the presence of HIV infection in the child, but the child is taken out of hospital sulfur formation from intranatal and perinatal contact with HIV infection in older adults 1 fate for the overnight revelation of advancing minds:
Indications for testing for DNA detection of HIV provirus
The diagnosis of HIV infection is excluded or established in children with perinatal transmission using serological and virological methods. Serological tests aimed at detecting antibodies to the virus in blood syringes using ELISA and immunoblotting. Virological methods (virus detection, PLR, viral invasion) make it possible to detect the virus and/or its components - proteins and nucleic acids, zocrem, gp24-aHTHreH, which are located in the warehouse of viral particles at significant locations. benefits. Evidence and early serological diagnosis of HIV infection in children is complicated, fragments of antibodies of the IgG class are transmitted from the mother transplacentally and are present in children under 18 months. It is impossible to reduce maternal and biological antibodies to VIL. In uninfected children, maternal antibodies begin to disappear up to 9-12 months, which, with negative PLR, allows us to talk about the prevalence of infection in the child. The results of serological testing of newborn children are provided to the insurance company upon the residual diagnosis of any child. However, in some cases, antibodies may not be detected in HIV-positive children. This is associated with congenital hypogammaglobulinemia, if during the period when maternal antibodies are already present (6-18 months), their antibodies are not converted to VIL antigens at titers sufficient for detection in IFA. Thus, a negative result of serological testing in early life There appears to be insufficient information about the severity of the infection.
To establish or completely screen out HIV infection in newborns and early children, virological tests are recommended.
The most reliable methods are the polymerase Lanczyg reaction (PLR) (DNA and RNA test) and culture-virology. Their test makes it possible to make a diagnosis in 30-50% of HIV-infected children immediately after birth and in 100% of children aged 3-6 months. What can we say about the reproduction of VIL in the child’s body? For diagnostics VIL infections In children, two types of tests can be difficult: it has been shown that they are not sensitive to sensitivity; the prote DNA test is much simpler and cheaper. It is important to obtain reliable results using a test station for analyzing the venous blood of a child. The PLR method is highly sensitive: a few copies of DNA or RNA in a plasma sample can be sufficient for the test result to be positive. Therefore, the umbilical cord blood is not suitable for molecular testing. Due to the possibility of contamination of the baby's blood with maternal blood during pregnancy; The smallest accumulation of viral particles or lymphocytes of the HIV-infected mother can lead to a positive result of the LCR analysis, which will complicate the establishment of the correct diagnosis of the child.
According to experts, diagnostic PLR testing should be carried out three times at the beginning of life: from birth to 48 years of age; in women 1-2 months; -4-6 m. Most fakhivtsi agree on the opinion that when infected in uteri, a positive result of virological surveillance in the first 48 years of life is avoided. As children grow up around the world, HIV DNA is detected during DNA testing. In case of perinatal infection, in the first 7 days, only 24% of infected children are detected, and after this period it becomes 93%. Therefore, in most infected children, a diagnosis of HIV infection can be made as early as 1 month. with repeated PLR analysis.
Children who show negative results of virological testing at 1 month of age are monitored for 4-6 months. Until the age of 4-6 months, almost all HIV-infected children will have positive PLR test results.
Another test for assessing the virological status and monitoring the infection is the measurement of viral intensity - the concentration of the virus expressed among copies of VIL RNA (proportional number of viral particles) per 1 ml plasma. Characteristic for children high rіven viral infection, which can persist in the child’s body for a long time. It has been shown that with intrauterine infection at the time of birth, the concentration of the virus is remarkably low<10 000 копий/мл), однако в течение первых 2 месяцев жизни резко возрастает (100 000 — 1 000 000 копий РНК/ мл и более) и затем снижается очень медленно в течение нескольких лет. Высокий уровень вирусной нагрузки (более 105/мл в возрасте 1-2 мес. обычно соответствует быстрому прогрессированию ВИЧ-инфекции. Для детей характерны более выраженные биологические колебания концентрации вируса в крови, поэтому в возрасте до 2 лет существенными следует считать не менее чем пятикратные различия показателей (для взрослых — 3-кратные). В результате проведенных исследований в США выявлена зависимость уровня РНК ВИЧ и показателей смертности от пола ребенка. Отмечено, что для мальчиков характерен более высокий уровень РНК ВИЧ, но не смотря на это, выживаемость мальчиков существенно выше выживаемости девочек. Показатели вирусной нагрузки имеют значение для оценки состояния, прогноза и решения вопроса о назначении и эффективности антиретровирусной терапии. При хорошем результате лечения уровень нагрузки падает в 100-1000 раз и может оказаться ниже порога чувствительности тест - системы (так называемый «неопределяемый уровень»).
Thus, children are aged between 6 and 18 months. With the combination of two methods – serological and virological – it is possible to confirm or eliminate HIV infection. It is possible to obtain information about the absence of daily life in children without clinical signs of HIV infection for two negative results of serological and virological tests. If positive virological and serological results are confirmed, infection is confirmed. After 18 months. Single confirmations of HIV infection may result in the presence of antibodies to HIV infection in a sick child: after this term, stinks may appear there only in those who are generated by the immune system in Report contact with the virus.
The life of a person with VIL is completely at a standstill once illness has been diagnosed. To identify pathology, it is enough to perform a simple blood test. If a person has an immunodeficiency virus, then the analysis will show damage to the functioning of the body.
The presence of the virus cannot be detected in a complete blood test, but factors can be identified that clearly indicate the presence of pathology in the body.
The normal volume is 1.2-3×109/l. At the early stages, this indicator moves forward, which indicates the body’s fight against illness.
If the immune system is already weakened and cannot resist the virus, the number of lymphocytes will decrease to a critical level.
During the course of immunodeficiency, changes in T-lymphocytes are avoided.
Neutrophils begin to be active immediately after viruses enter the body. These elements remove the clay from viral cells.
In case of IL, one should be careful about the ruination and the value of the change in the number of neutrophils.
The normal quantity of neutrophils in the blood is 1.8-6.5×109/l. The reduced quantity of these elements is characteristic of VIL, as well as other diseases of the infectious-ignition type.
Mononuclear cells are a type of leukocyte. Establishes itself in the blood only after everyday infections and viruses penetrate the body. In a normal state, these elements of combustion are not to be found in the blood.
Play one of the main roles while the blood is throaty. The normal content of these elements in the blood is 150–400×109/l.
As VIL develops, the number of platelets decreases.
Clinically, this condition is confirmed by the presence of a number of symptoms:
Rhubarb is not considered specific for the pathology analyzed. In case of IL, the quantity of these elements changes due to the infusion of the virus into the cystic spores, where hematopoiesis occurs. The normal volume of erythrocytes in the blood is 3.7–5.1×1012/l.
Rarely, a complete blood test may reveal changes in these elements. This is the way to be careful with pulmonary illnesses that accompany VIL. Such pathologies include tuberculosis and inflammation of the leg.
A sign of VIL is a decrease in the amount of hemoglobin, which is recognized as a symptom of lizoid deficiency.
The following symptoms are recognized:
Normal hemoglobin level is 120-160 g/l.
When diagnosing the immunodeficiency virus, a significant increase in red blood cells is detected. The normal rate is 1 to 15 mm/year. Accelerated settling is not considered a specific indicator for VIL. This symptom is characteristic of any infectious-ignition illness.
The erythrocyte sedimentation fluidity may not change for three hours (up to several times), after which it increases sharply.
As a result, it is possible to have an uncertain outcome, so that the UAC does not allow the possibility of 100% conversion in the presence of VIL and SNID. However, this method of detection is very important for detecting the virus at the germ stage.
If children are required to take additional IFA, they need to prepare before the procedure. For children, preparation before the analysis follows a pre-natal dietary regimen. It is necessary to turn off salted, cooked and fatty vegetables from the menu.
Blood collection ends with the fastening of the boat. The biomaterial is taken from the veins in a quantity of 5 ml.
Since the doctor's office is paid, you can see the results as early as the next day. In state-owned clinics, the period of focusing on results lasts for many years. If the result is negative, the child may have an immunodeficiency virus.
If, during the investigation, specific antibodies were detected in the biomaterials, a positive result is given, which indicates the presence of VIL.
If you perform an immunoblot analysis in parallel, you can obtain reliable information. The combination of ELISA and immunoblot results gives a result with 99.9% confidence. If the results are not consistent, this means that the analysis is unreliable and must be retaken.
The main difference between these diagnostic methods lies in the fact that the analysis for HIV virus (SNID) is more accurate, early and necessary for complete diagnosis and treatment.
Although the antibody test does not have such accuracy, it does have the obvious advantage of low price and short preparation time.
At the “Polyclinic +1” clinic, tests for antibodies to VIL (SNID) can be performed in 20 minutes, blood is drawn from a vein. The cost of such an analysis is 500 rubles. You can submit this and other analyzes completely anonymously.
Tests for HIV virus (SNID) become positive, starting from 5-7 days after the moment of infection, gradually increasing the number of detections and reaching 100% up to 30-40 days.
It is important to note that in the early stages of possible infection it is possible to undergo prophylaxis against VIL infection. This type of prevention has been well tested for HIV-infected vaginal diseases, most popular among children. As a result of such prevention, 3 out of 4 children are healthy.
Tests for HIV virus (SNID) are carried out in two ways:
Analyzes for antibodies (IFA) to VIL (SNID) remain in the body and begin to show positive results after 2-3 days, the maximum reliability of detecting such an analysis may be 6 months after infection. When testing for antibodies to VIL (SNID) is carried out, the reaction is determined by a primary laboratory; in case of a positive test, the blood is sent to a specialized laboratory of VIL. In this case, the patient is informed that the blood will stop for 10-15 days. Only a specialized VIL laboratory can provide information about a positive antibody test for human immunodeficiency virus.
At the “Polyclinic +1” clinic, tests for antibodies to VIL can be carried out in 20 weeks, which involves drawing blood from a vein.
The usefulness of such an analysis 500 rubles. You can do this and other analyzes in full ANONYMOUS.
We look forward to seeing you at our clinic.
HIV infection is not transmitted to most children born to HIV-positive mothers
20% – under the hour of pregnancy.
60% – during the canopy period.
20% - with breast support.
Prevention of vertical transmission (VVT) is a complex of approaches aimed at the early transmission of VIL from mother to child at all possible stages (vagity, pregnancy, pregnancy).
For a healing look at Ditini, it is not possible to re -abandon the directed to the regional center of SNIDA 1 MISYAC, de yoma, Zdinnika, blood on the vale of RNA vil by the Voznoennnya Antitil to VIL method Ifa. Further tactics for conducting the child will depend on the results of the investigation.
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IMPORTANT: VIL-positive children attend kindergartens and schools in sheltered settings Over the years, fathers who are informed about the child’s VIL status may be deprived of the medical staff of the children’s establishment or school.
IMPORTANT: VIL-positive children undergo intensive rehabilitation at child health clinics that match the profile
