SS Chiu, YL Lau

Abstract

To date, almost 1500 people infected with the human immunodeficiency virus have been reported in Hong Kong. The number of children infected perinatally is relatively small: 11 children have been identified and reported. We review our experience in caring for 8 of these children at Queen Mary Hospital since January 1996. Five children originally thought to be healthy were diagnosed because a parent tested HIV positive. Three children presented an AIDS defining illness. Only 2 of the presumed asymptomatic children had normal absolute CD4 counts and percentages. All 8 children had high HIV viral load at the time of diagnosis. They were treated with highly active anti-retroviral therapy (HAART) with favourable response. Except for 2 patients, all have achieved a sustained viral suppression to an undetectable level. One patient died of lymphoma despite an undetectable viral load. Five children were diagnosed because a parent tested HIV positive. Three children presented with symptoms suggestive of HIV infection. Other aspects of care including cost as well as some of the difficulties in caring for these children are highlighted. The need for a policy for universal screening of pregnant women in order to benefit from the effective antiretroviral regimen for reducing perinatal transmission of HIV is also discussed.