How to prevent HIV / AIDS?
Last reviewed: 23.04.2024
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Prevention of HIV infection
The antiepidemic regimen for HIV infection is the same as for hepatitis B. In pediatrics, the system of preventive measures should be based on the fact that children usually become infected with HIV in high-risk families (AIDS patients, drug addicts, bisexuals, etc.). In this regard, the main preventive measure can be considered a worldwide struggle for a healthy lifestyle, as well as educational activities to combat prostitution, drug addiction, sexual perversion, etc.
Clinical and serological control of blood donors, the use of disposable instruments, the control of the safety of hemodialysis systems, etc. Are of great preventive importance.
Prevention of mother-to-child transmission of HIV
Chemoprophylaxis of HIV transmission from mother to child is carried out during pregnancy, during childbirth and at the newborn.
The most successful results are provided by carrying out all three components of chemoprophylaxis. However, if any of the components can not be performed, this is not a reason for rejecting the next component.
High-grade chemoprophylaxis reduces the risk of infection of the child from 28-50 to 3-8%.
Vaccine prophylaxis for children born to HIV-infected women
All children born from HIV-infected mothers can be vaccinated in a calendar time with killed vaccines (DTP, ADS and hepatitis B), regardless of the severity of clinical manifestations and immunological changes. However, one must take into account that the immune response to some vaccines or their components can be reduced. In such cases, an additional booster dose of the vaccine is recommended.
In addition to calendar inactivated vaccines, specific immunization against diseases caused by Haemophilus influenzae type b (from 3 months), pneumococcal infection (after 2 years), meningococcal infection (from 1 year), influenza (from 6 months), hepatitis A according to the instructions to the vaccine).
Children with an unidentified HIV status and HIV-infected with clinical manifestations and immunodeficiency are given an inactivated polio vaccine triple in accordance with scheme 3; 4.5; 6 months with a booster at 18 months, at 6 and 14 years. An inactivated polio vaccine should be administered to children living in a family with an HIV-infected person.
HIV-infected children are recommended vaccination against measles, mumps and rubella. Instead of the domestic measles vaccine, it is possible to inject foreign combined vaccines against three infections (Prioriks MMR II, etc.).
There may be insufficient antibody titers in children with clinical manifestations of HIV infection in the AIDS stage and / or severe immunodeficiency (less than 15% or less than 500 cells / μl in a child of the 2nd year of life), which is the basis for the administration of 2 dose of the vaccine as soon as possible (after 4 weeks). If there is a pronounced deficit of the cellular immunity, vaccinations are not carried out with live vaccines.
The issue of vaccination against the tuberculosis of a child born to an HIV-infected mother is decided after a definitive diagnosis is established at the age of 18 months.
BCG is contraindicated in children with manifest stages of HIV infection (clinical categories B, C for CDC) and / or immunodeficiency (2nd and 3rd immune categories for CDC, leukopenia, lymphopenia, neutropenia, thrombocytopenia of any degree).
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