Mahdi, MohamedNwolu, Favour Ntor-obari2016-09-152016-09-152016-08-01http://hdl.handle.net/2437/230476Infection with the human immunodeficiency virus (HIV) is a well known pandemic in all of history. As stated by the World health organization (WHO), the disease has claimed over 39 million lives worldwide [1]. Acquired Immunodeficiency syndrome (AIDS) was first recognized in 1981 among homosexual men that presented with rare opportunistic infections and malignancies. The causative agent HIV was later discovered in 1983 [2]. HIV belongs to the genus Lentivirus of the Retroviridea family. The virus is mainly transmitted via unprotected heterosexual or homosexual contact, vertical transmission from mother to fetus or newborn, shared intravenous drug apparatus, and through contaminated blood and blood products. HIV has two main subtypes; HIV-1 and HIV-2, of which HIV-1 is more virulent. HIV-1 is believed to have originated from cross species transmission from chimpanzees in Central Africa while HIV-2 has been linked to simian viruses that infect sooty mangabeys in Western Africa. Both subtypes have a similarity in their structural gene organization, and replication cycle. However, HIV-2 is less pathogenic and tends to cause a much longer latency period [3]. HIV-1 has a higher risk of transmission, is more aggressive, and has a faster rate of progression to AIDS, while HIV-2 has a lower risk of transmission, is less aggressive, and is associated with a longer latency period and slower progression to AIDS [3]. It is believed that HIV evolved from Simian Immunodeficiency Virus (SIV) as a result of in-host viral recombination. HIV-1 descended from SIV chimpanzee; a strain of SIV while HIV-2 has diverged from SIV sooty mangabey variant [4]. Theories have been proposed explaining how HIVs were transferred from animals to humans. The hunter theory is the most accepted theory; in which it is implied that the virus was transmitted during hunting activities, through cutaneous exposure to infected primate blood. Another rather controversial theory is the oral polio vaccine theory that suggests that the virus was transferred iatrogenically via polio vaccines developed in infected cells. The colonization theory suggests that during the colonial era the colonizers may have been infected by the virus and helped spread the virus worldwide by bringing souvenirs and slaves at the end of the colonial era [4]. Over 95% of pediatric HIV infections are acquired via mother-to-child transmission (MTCT) especially during labor and delivery [5]. The introduction of antiretroviral therapy (ART) and alternative mode of delivery via caesarean section has led to successful reduction in perinatal transmission of HIV. Postnatal transmission via breastfeeding is also implicated; hence the recommendation that breastfeeding should be avoided. Certain maternal and obstetric factors increase the rate of HIV transmission such as: prematurity, advanced maternal disease, and high maternal viral load [5]. Thanks to easy access to anti-retroviral drugs in developed countries, there has been a remarkable reduction in MTCT; new pediatric infections are more common in developing countries where antenatal screening is not comprehensive and interventions to reduce MTCT are not widely offered. [6] The aim of my thesis is to discuss AIDS in the pediatric population and also to briefly brush on the role of sexual abuse in the transmission of the infection. The focus of this thesis is the pediatric population suffering from this pandemic, emphasizing epidemiological and demographical aspects, in addition to reviewing the clinical characteristics and treatment protocols.43enAIDSHAARTHIVDEENK Témalista::Orvostudomány