Prevention

Infants can contract HIV during a natural delivery, and cesarean delivery can decrease the likelihood that this will occur. However, a C-section is by no means a routine option when the mother is infected with HIV or has AIDS. The more invasive nature of the C-section can create risks for mother and child, additional costs, and danger to health workers exposed to the mother's infected blood.

Fortunately, medications can safely be given to mother and child that prevent HIV transmission. To prohibit transmission of the virus, mothers are given intravenous zidovudine (AzT) during their second and third trimesters. Infants are then given a six-week course of AZT by mouth. This intensive treatment has greatly reduced transmission of the disease. Multidrug regimens have also been used to treat pregnant women with even more promising results.

There are three classes of medications currently available for treatment:

• nucleoside antiretrovirals: zidovudine (AZT), DDI,

• protease inhibitors: indinavir, nelfinavir, ritonavir, saquinavir

• non-nucleoside reverse transcriptase inhibitors

(NNRTIs): nevirapine, delavirdine, efavirenz

Because these medications work in different ways, doctors generally prescribe a "combination cocktail" of these drugs. Most of these treatments have been studied in children. While a number of drugs are available to treat HIV infection and slow the onset of AIDS, unless they are taken and administered properly, the virus quickly becomes resistant to the particular mix of medications. This means that if a treatment plan is not followed precisely, a new regimen will need to be established with different drugs.

If this is not followed, the virus will in turn become resistant to it. Because the number of drugs in each class is still limited, the very real danger is that children can quickly use up all the potential treatments, especially if they resist taking their medication. In addition to the difficulty of getting young children to take their medication on a timed schedule, the medications also have unpleasant side effects, such as a bad flavor, while others are only available in pill form, which may be difficult for children to swallow.

humidifiers The use of a humidifier in a child's bedroom during the winter can help keep mucous membranes moist and healthy—but poorly maintained humidifiers can be the source of infection.

The nose, throat, and lungs work best when the air has a relative humidity of about 40 percent. If the air during the winter falls below that level, moisture will be absorbed into the heated air from the mucous membranes. Since dried mucous membranes cannot clean themselves, they become more vulnerable to invasion from cold viruses. A well-maintained humidifier can keep the air humid and nose and throat moist.

However, it is important that the device be used correctly. If the air becomes too humid, or the machine is not properly cleaned, mold and dust mites can multiply. To keep the risk of infection from molds or bacteria to a minimum, the humidity should not be allowed to rise above 40 percent. In addition, the water reservoir in the humidifier should be cleaned daily with a vinegar solution.

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