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Drug therapy for HIV infected 18 month old?
Jun 21, 2003

PLEASE HELP!

We have adopted 18 month old twins from Tanzania, Africa. The little girl is HIV+ and we need some advice as to whether we should be starting medication now or not, and if so - what medication to use. We are still living in Tanzania and will be for another year. The testing available here is very unreliable and so assertaining T-Cell counts would not be possible. I am not even sure whether the HIV test is relaible. Is there any drug that we could be giving her to boost her immune system until we get back home to Europe and can start intensive therapy? Can you give us any general advice about small children and HIV treatment - when to start, what to take etc? The doctors here do not really know and the medication is unlikely to be available anyhow - but anything that we could be giving her to help her, we would love to do so.

Thank you so much for your help.

Response from Dr. Wohl

Hi

Whether your daughter is a candidate for HIV therapy depends predominantly on the strength of her immune system at present and whether she has any symptoms or signs of HIV disease.

I am not sure where you are in Tanzania but there are ways to get a T-cell (CD4 cell) count in Dar es Salaam and in Arusha. Some of the private hospitals may also be able to do this efficiently, but at a cost. Be sure to also check with your embassy/consulate if you are EU citizens as they may be able to point you in the right direction. (If you are worried the test will be inaccurate repeat it soon after the first and compare the difference.)

Similarly, if you can find a knowledgeable HIV treater (they are there) HIV medicines can be purchased. Again, it costs money.

Of course, the alternative, as you point out is to take her abroad.

Besides good nutrition, getting all her vaccines, and making sure she gets any prophylactic antibiotics she may require to prevent AIDS related infections, there is not much else you can do to boost her immune system. I would avoid local remedies that advertise otherwise.

Once you get a T-cell count, please let us know and I will make sure a pediatric HIV specialist addresses any specific questions. DW



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