Module2-Care of the HEI-2007

Module2-Care of the HEI-2007 - Care of the HIV-Exposed...

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Care of the HIV-Exposed Infant
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Objectives This presentation will review: The distinction between HIV-exposed and HIV- infected infants The goals of care for HIV-exposed infants The challenges in implementation of care and follow up of HIV-exposed infants Routine care procedures for HIV-exposed infants
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Who is an HIV-Exposed Infant An infant born to an HIV-infected mother The infant is of unknown HIV infection status, but may be HIV-infected
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Goals of Care of the HIV Exposed Infant Preventing opportunistic infections Identifying the HIV-infected child EARLY Maximizing infant and family health and well being Retaining infants in care until final infection status is determined
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Why is it important to engage and retain infants in care? High rates of illness and death in infants Infants without HIV infection IMR is high in most developing countries Infants with HIV infection Are at increased risk for early death Early and frequent interaction with health care providers should lead to improved health outcomes (decreased morbidity and mortality) Initiation of routine health interventions for infants of HIV-infected mothers
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Caring for HIV-exposed Infants Begins During Pregnancy! The easiest way to identify HIV-exposed infants is to identify the HIV-infected woman during pregnancy Maximize maternal health status - children and communities need healthy mothers! Childhood mortality increases significantly with maternal death Conduct clinical and immunological staging for all HIV-positive pregnant women – ASAP! pMTCT: ART when indicated, pMTCT prophylaxis, infant feeding counseling should begin early CTX when indicated: may have benefits for neonatal health
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Challenges to Care-1 Infants can be infected with HIV during pregnancy, during labor & delivery, or postpartum (through breastfeeding) All exposed infants (infected and non-infected) will test HIV antibody positive during the first months of life While the child with HIV infection can frequently be identified during the first months of life, HIV infection often cannot be excluded until > 1 year of age particularly in breastfeeding infants Most infants are lost to follow-up before final infection status is determined
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Challenges to Care-2 Pediatric HIV disease can progress very rapidly and may require treatment before HIV infection can be confirmed HIV-infected infants are susceptible to many opportunistic infections (OIs) including PCP, TB, and bacterial infections that are associated with high rates of infant mortality Without treatment 50 % of HIV-infected children will die by 2 years of age
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Clinical Objectives Closely monitor HIV-exposed infants for evidence of HIV infection and failing health status Prevent opportunistic infections by providing prophylaxis to all HIV-exposed infants Identify and treat the HIV-infected infant as early as possible
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How can this be achieved? Identifying HIV-exposed infants early and
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Module2-Care of the HEI-2007 - Care of the HIV-Exposed...

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