Late diagnosis of Aids in children: reviewing lost opportunities in prophylaxis of mother-to-child transmission and early diagnosis of HIV

Abstract

Objective: most of the HIV infections in children are due to the mother-to-child transmission, which is the leading mechanism of HIV transmission in this age group. The implementation of effective measures aiming to decrease vertical transmission was successful, reducing it to less than 1% amongst children exposed to the virus. Early diagnosis is related to lower rates of morbidity and mortality in the affected population. This article aimsto report a clinical case of late diagnosis of HIV infection in a child, debating the missed opportunities in the prophylaxis for vertical transmission and in the early diagnosis of the infection. Case description: this article reports a case of an eight-year-old boy. Due to irregular prenatal appointments, his mother was diagnosed with HIV only at the moment of birth. After hospital discharge, she did not seek medical follow-up for the child, despite being told so. The boy had parotitis, lymphadenomegaly, and one episode of pneumonia. Following this, he was referred to outpatient follow-up to further investigate his diagnosis, but he was not brought to the appointment. HIV diagnosis was made after his second hospitalization, in which both mother and child had been diagnosed with pulmonary tu berculosis. Tuberculostatic drugs were initiated, as well as the combination antiretroviral therapy. Currently, the child is being followed-up in outpatient services, showing a good adherence to the treatment. Discussion: this case reinforces the importance of early diagnosis of HIV infections in children, which is decisive to avoid the progression of the disease, improving its prognosis.