Health experts have said that India is planning to start an exercise to estimate the number of children who are infected with HIV and need anti-HIV therapy to extend their lives.
Experts of the National AIDS Control Organisation and Indian paediatricians are starting to work on trying to forecast the need for anti-HIV drugs for children and provide training to medical professionals in diagnosis and treatment of paediatric HIV. The growing concerns that obstacles are preventing anti-HIV therapy from reaching children, is the primary reason for the stat of this exercise.
The World Health Organisation and Unicef are of the estimate that 660,000 HIV-infected children, younger than 15 years, are in need of anti-HIV therapy around the world. But according to Siobhan Crowley, medical officer with WHO, Geneva just 3% of children who need this therapy are receiving it.
Babies can get HIV from HIV-positive pregnant women who have not been treated with anti-HIV drugs. Though the Indian government is offering anti-HIV treatment to prevent mother-to-child transmission, not all infected women get the therapy. Estimates done in Southeast Asia suggest that an estimated 40,000 children were born last year with HIV. The figure is based on the rates of transmission from mothers to children and estimated prevalence of HIV among pregnant women.
Siobhan Crowley is of the opinion that the lack of paediatric anti-HIV drug formulations is a big obstacle. While stating that anti-HIV therapy involves a combination of drugs, she said that there are no combination tablets tailored for young children. This she feels makes treatment difficult to administer.
Explaining that about 30% of newly infected children die before their first birthday and 50% die before the age of two, she said that this makes it important to start treatment early. However, she also added that the diagnosis of HIV is also a problem. Since infected children pick up anti-HIV antibodies from their mothers, standard diagnostic tests that look for antibodies cannot tell whether the children are indeed infected with the virus she explains. She said that there are sophisticated diagnostic tests to confirm the presence of the virus, but they are not available everywhere.
Ms Crowley said international agencies are now urging manufacturers of generic anti-HIV drugs to formulate appropriate combinations for children. Anti-HIV treatment is not a cure for HIV and has to be taken by an infected person throughout life. In developed countries, experts have said that children who started taking the anti-HIV combination drugs in the early 1990s are doing fine as adults now, although they continue to take second-generation anti-HIV drugs.
About 23,700 HIV-positive persons are now on anti-HIV drugs in India. Among these, 1,300 are children.