Analysis and Interpretation

HIV diagnosed through blood testing, but it may take more than one set. The diagnosed
can be confirmed if the blood contains HIV antibodies. But early on in the course of infection,
antibody levels may not be high enough for detection. If the test is negative but HIV is
suspected, the least can be repeated in 3 months and again at 6 months.

Symptoms vary from child to child and with age. Child and teens may have skin rash,
oral thrush, frequent vaginal yeast infections, enlarge liver or spleen, lung infections kidney
problem and others

HIV may not have current cure, but it can be effectively treated ad managed. Today,
many children and adults with HIV live long, healthy lives. The main treatment for children is
same as adults: antiretroviral therapy. Antiretroviral therapy and medications help prevent HIV
progression and transmission. Treatment for children requires a few special considerations. Age,
growth, and stage of development all matters and have to be reassessed as the child progresses
through puberty and into adulthood.

Other factors to take into account include:

 Severity of the HIV infection

 The risk of progression
 Previous and current HIV-related illness
 Short-and-long term toxicities
 Side effects
 Drug interactions

Antiretroviral therapy involves a combination of at least three different antiretroviral drugs.

When choosing which drug to use health care providers consider the possibility of drug
resistance, which will affect future treatment options. Medication may have adjusted from time
to time.

Parents and caregivers also need to work closely with health care providers. In some cases,
family counseling may be beneficial for everyone involved. Adolescent living with HIV may
also needs mental health counseling and support groups, substance use screening, support for
smooth transition into adult healthcare and many more

Be sure to keep your child’s healthcare provider informed of new or changing symptoms, as
well as medication side effects. Never hesitate to ask questions about your child’s health and
treatment.

Acquired immunodeficiency syndrome (AIDS) is a serious secondary immunodeficiency

disorder caused by the retrovirus, human immunodeficiency virus (HIV). Both diseases are
characterized by the progressive destruction of cell-mediated (T-cell) immunity with subsequent
effects on humoral (B-cell) immunity because of the pivotal role of the CD4+helper T cells in
immune reactions. Immunodeficiency makes the patient susceptible to opportunistic infections,
unusual cancers, and other abnormalities.

Assessment and Diagnostic Findings

Several screening tests are used to diagnose HIV infection. Confirming Diagnosis: Signs and
symptoms may occur at any time after infection, but AIDS isn’t officially diagnosed until the
patient’s CD4+ T-cell count falls below 200 cells/mcl or associated clinical conditions or
disease. CBC: Anemia and idiopathic thrombocytopenia (anemia occurs in up to 85% of patients
with AIDS and may be profound). Leukopenia may be present; differential shift to the left
suggests infectious process (PCP), although shift to the right may be noted. PPD: Determines
exposure and/or active TB disease. Of AIDS patients, 100% of those exposed to
active Mycobacterium tuberculosis will develop the disease. Serologic: Serum antibody
test: HIV screen by ELISA. A positive test result may be indicative of exposure to HIV but is not
diagnostic because false-positives may occur. Western blot test: Confirms diagnosis of HIV in
blood and urine. RI-PCR: The most widely used test currently can detect viral RNA levels as low
as 50 copies/mL of plasma with an upper limit of 75,000 copies/mL. bDNA 3.0 assay: Has a
wider range of 50–500,000 copies/mL. Therapy can be initiated, or changes made in treatment
approaches, based on rise of viral load or maintenance of a low viral load. This is currently the
leading indicator of effectiveness of therapy. T-lymphocyte cells: Total count reduced.
CD4+ lymphocyte count (immune system indicator that mediates several immune system
processes and signals B cells to produce antibodies to foreign germs): Numbers less than 200
indicate severe immune deficiency response and diagnosis of AIDS. T8+ CTL (cytopathic
suppressor cells): Reversed ratio (2:1 or higher) of suppressor cells to helper cells (T8+ to T4+)
indicates immune suppression.

Polymerase chain reaction (PCR) test: Detects HIV-DNA; most helpful in testing newborns of

HIV-infected mothers. Infants carry maternal HIV antibodies and therefore test positive by
ELISA and Western blot, even though infant is not necessarily infected. STD screening
tests: Hepatitis B envelope and core antibodies, syphilis, and other common STDs may be
positive. Cultures: Histologic, cytologic studies of urine, blood, stool, spinal fluid, lesions,
sputum, and secretions may be done to identify the opportunistic infection

There is no cure yet for either HIV or AIDS. However, significant advances have been made
to help patients control signs and symptoms and impair disease progression. Nursing Diagnosis
for Imbalanced Nutrition: Less Than Body Requirements may be related to Inability or altered
ability to ingest, digest and/or metabolize nutrients: nausea/vomiting, hyperactive gag reflex,
intestinal disturbances, GI tract infections, fatigue and increased metabolic rate/nutritional needs
(fever/infection). Possibly evidenced by Weight loss, decreased subcutaneous fat/muscle mass
(wasting), Lack of interest in food, aversion to eating, altered taste sensation, Abdominal
cramping, hyperactive bowel sounds, diarrhea, Sore, inflamed buccal cavity and Abnormal
laboratory results: vitamin/mineral and protein deficiencies, electrolyte imbalances. Desired
Outcomes are Maintain weight or display weight gain toward desired goal and demonstrate
positive nitrogen balance, be free of signs of malnutrition, and display improved energy level.