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Medical
Resources :: General Medical Issues :: HIV Infection in Children Adopted
from Abroad
What does HIV look like today? Currently, there are 30 million untreated
people with AIDS in the world. "The number of untreated victims of
AIDS who have died since effective drugs became available will exceed
the 25 million people who died from the black death in Europe more than
600 years ago." George Watt, M.D. NEJM vol. 346, no.9 Feb 28, 2002
| HIV in Vietnam |
| Agence France Press, Mar-13-2002 |
| • More than half of registered prostitutes
in HCMC now carry the AIDS virus |
| • Infection rates in Hanoi were even
higher |
BACK TO TOP
| HIV in China |
| Zunyou Wu, National Center for AIDS Prevention
and control, Chinese Academy of Preventive Medicine, Beijing Health
Policy and Planning:16 (1): 41-46 Oxford University Press 2001 |
| • Thousands of commercial plasma collection
centers were established in counties, townships, and villages in China
between 1990 and 1994, the majority in rural areas. Donating plasma
for money was an easy way for rural farmers to augment income. |
| • HIV was spread via repeated plasma
donations, transfusions, and then heterosexual spread ensued |
| • Lack of acknowledgment of these trends
led to extensive spread all over China |
| • August 2001, the Chinese government
acknowledged a serious AIDS crisis |
| • 600,000 is a serious underestimate
of the number of people infected (1.5 million) |
| • Yunnan province drug abuse since
the late 80s |
| • Golden Triangle--southwest China
near the borders of Laos, Myanmar, and Thailand where injection drugs
and needle sharing dominate |
| • More than a half a million people
in Central China may have become infected by selling their blood in
the 90s |
| • Henan province was the focus of recent
publicity regarding the spread of AIDS in China |
| • New York Times series by Elizabeth
Rosenthal 1999 to present exposed the AIDS crisis in China |
BACK TO TOP
| HIV in Eastern Europe |
| UNAIDS report, AIDS Epidemic Update,
December 2001 |
| • Feb 11, 2002 Reuters/Moscow Dr. Vadim
Pokrovsky,head of the AIDS center, reports Russia and Ukraine HIV
infection spinning out of control |
| • Russia 180,000 registered HIV patients |
| • Prevalence is reportedly over one
million or 1% of adults and is still due to drugs |
| • More than 82 of Russian Federation’s
89 regions have now reported HIV cases |
| • Ukraine data 240,000 at end of 1999 |
| • Belarus 14,000 adults and children
living with HIV/AIDS by end of 1999 |
BACK TO TOP
| HIV in India |
| • A few thousand in the early 90s to
current estimate of about 3.8 million children and adults living with
HIV/AIDS in 2001 |
| • Heterosexual transmission dominates |
| • 79% of HIV infections are men |
| • Epidemic is shifting towards women
and children |
| • National AIDS Control Programme 1987 |
BACK TO TOP
| HIV Infection in Children Adopted from
Abroad |
| • 7299 + children tested
in 17 centers in the U.S. since the early 1990s |
| • 12 children with HIV infection (0.16%) |
| Russia |
1 |
| Cambodia |
4 |
| Romania |
4 |
| Panama |
1 |
| Vietnam |
2 |
BACK TO TOP
| Adoption Centers |
| Lisa Albers-Massachusetts |
238 |
| Jane Aronson-New York |
1500 |
| James Conway-Indiana |
173 |
| Nancy Hendrie-Maine |
200 |
| Margaret Hostetter-CT |
225 |
| Jerri Jenista-Michigan |
500 |
| Dana Johnson-Minnesota |
1188 |
| Edward Kolb-Nebraska |
92 |
| Jennifer Ladage-Missouri |
81 |
| Anna Mandalakas-Ohio |
400 |
| Laurie Miller-Massachusetts |
1453 |
| Todd Ochs-Illinois |
230 |
| Elaine Schulte-New York |
150 |
| Heidi Schwartzwald-Texas |
138 |
| Boris Skurkovich-Rhode Island |
? |
| Sarah Springer-Pennsylvania |
531 |
| Mary Allen Staat-Ohio |
300 |
BACK TO TOP
| HIV Infection in Children Adopted from Abroad |
| • Russia 12 month old girl in 1998 |
| • Cambodia all 4 negative in country |
| • Vietnam 2 negative in country |
| • Panama 1 negative in country |
| • Romania 2 negative in country, 2 known to be
infected before adoption |
| • 10/12 negative at time of adoption (83%) |
| • 59 Children HIV ELISA positive |
| • 12 HIV-infected, 47 non-infected |
| • 59 children born to mothers with presumed HIV
infection [59/7299 (0.8%)] |
BACK TO TOP
| HIV ELISA Positive Children Adopted from
Abroad |
| Cambodia |
20 |
|
|
| China |
9 |
Guatemala |
1 |
| Russia |
9 |
Panama |
1 |
| India |
6 |
Ethiopia |
1 |
| Romania |
4 |
Ukraine |
1 |
| Vietnam |
3 |
South Korea |
1 |
| Thailand |
3 |
|
|
BACK TO TOP
| HIV Testing in Children |
| • Children under 18 months may still
have maternal antibody |
| • HIV ELISA, Western Blot, PCR, P 24 antigen, HIV
culture |
| • Baby born to mother who is known to be infected
gets HIV ELISA, WB, PCR at birth |
| • F/U HIV testing at one month and then between
4-6 months of age |
| • If the PCR test is negative at least twice then
the child is considered to be negative for infection |
BACK TO TOP
| Dilemmas in HIV Testing of Orphans |
| • What happens to kids in orphanages
who test HIV positive by ELISA? |
| • 75% of children under 2 yo. who are ELISA positive
are not infected |
| • How to implement PCR testing? |
| • Quarantine? Triage? Treatment? Medical interventions? |
| • Agency responsibilities? Politics? Pride? |
BACK TO TOP
International Pediatric Health Services, PLLC
Dr. Jane Aronson, FAAP
338 East 30th Street, #1R
New York, NY 10016
P: 212.207.6666
F: 212.207.6665
E: E-mail
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