Treating children with HIV

As the three-year-old HIV-positive girl brought back from Australia receives tests in hospital, BBC News Online looks at the kind of treatment she may receive.

Treating a child with HIV is very similar to treating an adult with the condition.

Their care will depend on how advanced their infection is - how much HIV virus there is in the blood, and what their CD4 cell count is.

These cells are part of the body's defence system, but are attacked by HIV. As the condition progresses, a patient's viral load rises, but their CD4 count falls.

Once it reaches a very low level, the patient is susceptible to very serious, unusual infections - which is when they are diagnosed as having developed Aids.

The un-named three-year old is now being examined in hospital so that doctors can determine how the HIV has affected her.

Keith Alcorn, of the National Aids Manual, which advises professionals and patients on HIV treatment advice, said: "The treatment is not so different for a child of three as it would be for an adult - though for small babies it is different.

"Doctors will be looking at the levels of the virus in the blood and the state of her immune system."

Survival rates

"If the immune system damage is fairly advanced, she is vulnerable to bacterial infections or Cytomegalovirus, (a common virus which can cause problems in people with weakened systems), which could cause eye damage."

He said there had also been reports that Australian doctors had said there was some neurological damage - and tests would be carried out to see if that were the case.

Movement could be affected, or there could be learning difficulties.

Mr Alcorn added: "If any of these symptoms were present, then - in the opinion of most doctors in this country, that would be an indication of the need for treatment."

Dr Hermione Lyall of the Family HIV Centre at St Mary's Hospital, London, told BBC News Online: "Twenty per cent of children will actually reach the serious stage of the disease in the first year of life, developing severe infections - Aids."

But she said if they received urgent treatment, they tended to do well.

She added: "In Europe, 50% of children will still be alive and relatively well by the time they're 10-years-old, even before they've had combination therapy."

The girl's mother, who died last year, had ignored conventional medical advice to take drugs during pregnancy and not to breastfeed, so the risk of transmission would be removed.

Mother-to-child transmission can be largely prevented by anti-retroviral treatment during pregnancy.