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Will anti-retroviral treatment affect my five-month-old baby?

By Vision Reporter

Added 9th March 2008 03:00 AM

CD4 counts are usually high in children because the total lymphocyte count is also high in children. Lymphocytes to which CD4 cells belong are part of the white blood cells.

CD4 counts are usually high in children because the total lymphocyte count is also high in children. Lymphocytes to which CD4 cells belong are part of the white blood cells.

Dear Doctor
I am HIV-positive and have known my status since last year when I was pregnant. I started taking ARVs when I was six months pregnant.
I gave birth to a baby and when he was tested for HIV using the PCR method, he tested positive. A CD4 count was done and he had 265 cells/ml with a percentage of 30%. A certain doctor started him on anti-retroviral treatment (Stavudine, Lamivudine and Nevirapine). When I talked to another doctor, he said the percentage was high and the baby should not be on treatment. I was advised to do another CD4 count on the baby and if the percentage was still high though the CD4 count was low, the treatment should be stopped. Will this affect my baby’s health since anti-retroviral treatment, when started, is for life? Please help. My baby is just five months old.

Lucy

CD4 counts are usually high in children because the total lymphocyte count is also high in children. Lymphocytes to which CD4 cells belong are part of the white blood cells.

We, therefore, do not use the CD4 absolute count to determine the amount of damage HIV has done to the child’s immune system, but the CD4 count as a percentage of the total lymphocyte count. So the 30% may be as a result of a low total lymphocyte count.

For a child to have such a low CD4 count, he/she must be having a low percentage. So this casts some doubt on this result.

It is, therefore, advisable to have your child’s CD4 count repeated, preferably from another laboratory for comparison purposes.

The outcome will not, however, make a difference since the child is anti-retroviral therapy and it should not be stopped.
Some people think once HIV is diagnosed in infants, they should be put on treatment, irrespective of the CD4% count.

It is important that all HIV-positive parents have their babies tested as soon as possible so that care and treatment is started early if their children are HIV-positive.

This is because the first three years in a child’s life are every crucial to development. If treatment is delayed, the children may be stunted for life.
We no longer advise such parents to wait for 18 months to elapse before doing the antibody test.

A PCR test should be done as was the case here and diagnosis made early.
It is better for all women to check their HIV status before they conceive.

HIV in children is better prevented, as treatment and care are very difficult and expensive.

Of the 100,000 children who are estimated to have HIV in Uganda, only about 10% are getting care and treatment. The rest are likely to die before their second birthday.

Send your question on HIV to Health Editor, The New Vision. P. O. Box 9815, Kampala or health&beauty@newvision.co.ug

Will anti-retroviral treatment affect my five-month-old baby?

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