Horizontal transmission of HIV infection in an HIV-exposed child—An avoidable tragedy

Rosemary O. Ugwu

Department of Paediatrics and Child Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria;.

DOI: 10.4236/crcm.2013.26097                

Abstract

Exposure to infected blood/blood products through blood transfusion and use of contaminated sharp objects remain an important source of HIV infection. This report describes the case of a 52-month-old male child of an HIV-infected mother in whom perinatal infection was successfully prevented by maternal and infant antiretroviral therapy, elective cesarean section, and avoidance of breast-feeding. A DNA PCR test at 6 weeks was negative and a rapid antibody test at 18 months was seronegative. He presented to the Paediatric infectious disease unit with chronic fever, cough, diarrhea and weight loss 7 months after receiving a commercially donated blood (in a rural private hospital) and scarification marks (by a traditional healer) for a febrile illness with convulsion. He was found to be seropositive with severe immunosuppression. He however died a month after being initiated on antiretroviral drug.

Keywords

HIV-Exposed; Blood Transfusion; Scarification

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Morison, L. (2001) The global epidemiology of HIV/ AIDS. British Medical Bulletin, 58, 7-18. doi:10.1093/bmb/58.1.7
[2]	Buchanan, A.M., and Cunningham, C.K. (2009) Advances and failures in preventing perinatal human immunodeficiency virus infection. Clinical Microbiology Reviews, 22, 493-507. doi:10.1128/CMR.00054-08
[3]	Eneh, A.U. and Ugwu, R.O. (2011) Evaluation of the effecttiveness of the prevention of mother-to-child transmission (PMTCT) interventions in HIV-exposed children. Port Harcourt Medical Journal, 5, 121-129. doi:10.4314/phmedj.v5i2.65012
[4]	Adejuyigbe, E.A., Durosinmi, M.A., Onyia, F.N. and Adeodu, O.O. (2003) Blood transfusion related paediatric HIV/AIDS in Ile-Ife, Nigeria. AIDS Care, 15, 329-335. doi:10.1080/0954012031000105388
[5]	Zou, S., Dorsey, K.A., Notari, E.P., et al. (2010) Prevalence, incidence, and residual risk of human immunodeficiency virus and hepatitis C virus infections among United States blood donors since the introduction of nucleic acid testing. Transfusion, 50, 1495-1504. doi:10.1111/j.1537-2995.2010.02622.x
[6]	Ward, J.W., Holmberg, S.D., Allen, J.R., et al. (1988) Transmission of human immunodeficiency virus (HIV) by blood transfusion, screened as negative for HIV antibody. New England Journal of Medicine, 318, 973-978. doi:10.1056/NEJM198802253180803
[7]	Kostman, J.R. (2002) Testing for the virus. In: Buckley, R.M. and Gluckman, S.J., Eds., HIV Infection in Primary care, WB Saunders, Philadelphia, 20-23.
[8]	Phelps, R., Robbins, K., Liberti, T., et al. (2004) Window-period human immunodeficiency virus transmission to two recipients by an adolescent blood donor. Transfusion, 44, 929-933. doi:10.1111/j.1537-2995.2004.03364.x
[9]	Donegan, E., Stuart, M., Niland, J.C., et al. (1990) Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody—Positive blood donations. Annals of Internal Medicine, 113, 733-739. doi:10.7326/0003-4819-113-10-733
[10]	Medley, G.F., Anderson, R.M., Cox, D.R. and Billard, L. (1987) Incubation period of AIDS in patients infected via blood transfusion. Nature, 328, 719-721. doi:10.1038/328719a0
[11]	Hardy, D.B. (1987) Cultural practices contributing to the transmission of human immunodeficiency virus in Africa. Review of Infectious Diseases, 9, 1109-1119. doi:10.1093/clinids/9.6.1109
[12]	World Health Organization (WHO) (2008) Traditional medicine. http://www.who.int/mediacentre/factsheets/fs134/en/index.html
[13]	Pretorius, E. (2000) Traditional healers. In: Crisp, N. and Ntuli, A., Eds., South African Health Review 1999, Health Systems Trust, Durban, 249-256. http://www.hst.org.za/uploads/files/chapter18_99.pdf
[14]	Brewer, D.D. (2011) Scarification and male circumcision associated with HIV infection in Mozambican children and youth. WebmedCentral EPIDEMIOLOGY, 2, WMC 002206.