The use of better anti-HIV drugs in pregnant women has dramatically reduced mother-to-child transmission of the AIDS virus in Canada, but opportunities are still being missed for preventing some of those infections, and for early diagnosis and treatment of HIV in children, according to a specialist at Toronto's Hospital for Sick Children.
The HIV clinic at the hospital has seen "increasing numbers of high-risk infants born to either mothers with unknown HIV status who were considered at high risk due to behavioural risk factors or babies born to mothers who were known to be HIV-positive previously," says Dr. Jason Brophy, a pediatric infectious disease specialist and HIV researcher.
"We unfortunately have seen four new HIV-infected infants in the past year or so, suggesting a failure of the health-care system in identifying HIV-positive mothers and preventing infant infections. It's really an alarming trend."
Brophy says there have been several cases in which doctors missed HIV risk factors or misinterpreted symptoms in children, leading to delayed diagnosis and treatment. In fact, older children with more advanced HIV infection can have unusual symptoms that further delay diagnosis.
The cases also point to a need for increased screening of new immigrants, Brophy says. "There's been a big push to test adult immigrants when they come to Canada, but children seem to fall through the cracks for testing. We need to focus more attention on awareness of HIV but also on increasing resources to address immigrant health problems."
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