PEDIATRIC PROBLEMS OF HIV INFECTION AND SOLUTIONS IN SAINT PETERSBURG

Abstract

Survey objective: analysis of transmission routes of HIV infection, its course and treatment in children with the aim of determining the common problems and solutions. Materials and methods. Observation of 388 HIV-infected children at the age from month to 17 years was held for the purpose of analysis of common problems on the basis of Motherhood and Childhood Department of State Budgetary Healthcare Institution «St. Petersburg Center on Prevention and Control of AIDS and Infectious Diseases». Statistical processing of data was carried out using Statistica for Windows software (v. 8.0). Survey results. It was found that 363 of children were infected with HIV during perinatal period (93,6%), 23% (5,9%) were infected during childbirth and 2 children — through injected drugs (0,5%). Of the 16 children with perinatally acquired AIDS diagnosed in 2017, breastfeeding was reported in 6 (37,5%) cases that evaluates HIV-screening of sexual partners of pregnant women. 378 (97,4%) of children take ART when clinically, immunologically and virologically indicate. Of this number, first line ART regimen is used in 130 children (34,4%). 199 (80,2%) switched to second-line ART regimen due to adverse effects, 49 (19,8%) after virological failure. Prevailing adverse effects such as dyslipidemia (40,8%), polyneuropathy (22,6%) and anemia (12,6%) were a reason for switching to alternative regimen with combined medications. Presently, it is a great problem that parents or foster parents of a child — HIV-dissidents refuse of children care and treatment that led to lethal outcome in 18 cases. In light of this, pediatricians of Centers on Prevention and Control of AIDS have to protect children’s rights for health by making request and applications to the guardianship authorities, courts, prosecutors, law enforcement agencies. 57 appeals to these authorities have been made in total.