Self-Assessment Questions (SAQs) for Study Session 28
Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the following questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.
SAQ 28.1(tests Learning Outcomes 28.1 and 28.2)
What is meant by the term ‘HIV-exposed infant’? How is the child’s HIV status diagnosed?
HIV-exposed infants are infants born to HIV-infected mothers. The HIV status of such infants is regarded as unknown until a definitive rapid diagnostic test is carried out at the proper age and conditions (e.g. cessation of breastfeeding for longer than 6 weeks before the test), or until a DNA PCR test (that measures directly viral components in the blood) is performed. If the test confirms the presence of HIV in the infant’s blood, we considered the infant to be infected by HIV.
SAQ 28.2 (tests Learning Outcome 28.2)
Which of the following statements is false? In each case, explain what is incorrect.
A The progression of HIV infection in children is slower than that of adults because they have fewer viruses in their body.
B Rapid HIV testing can confirm HIV infection in a six-months-old infant born to an HIV-positive mother.
C ARV drug dosages should be adjusted as the child gains weight or grows.
D Young children normally have higher CD4 counts than adults, and it is better to use the CD4 percentage (instead of the CD4 cell count) as a criterion of whether to start them on ART.
Statements C and D are true.
A is false. Compared to adults, HIV infection progresses more rapidly in children, due to their immature immune system.
B is false. In children under the age of 18 months we do not use a rapid HIV test to confirm HIV infection, because maternally acquired antibodies can give a false positive test result. The definitive diagnosis of HIV at this age is done by using DNA PCR testing.
Read Case Study 28.1, and then answer the questions that follow it.
Case Study 28.1 Kebede’s story
Kebede is a one-year-old male child who is the last of three siblings. All of the three live with their grandmother who is 65 years old. You hear from the grandmother that the mother of the children died of AIDS six months after giving birth to Kebede, and their father died in an accident 10 months ago. The grandmother also explains to you that Kebede is not feeling well, and has had diarrhoea on and off for two months. He has also lost weight. The grandmother needs your help.
SAQ 28.3 (tests Learning Outcomes 28.1, 28.3 and 28.4)
- a.What do you say about Kebede’s HIV status?
- b.Explain what you should do for Kebede.
- c.Will screening his siblings for HIV help the family?
- a.Kebede is an HIV-exposed infant, since he was born to an HIV-positive mother. Remember that unless their HIV test result is confirmed, infants born to HIV-positive mothers are called HIV-exposed infants.
- b.You should teach the grandmother about HIV transmission and prevention. You should stress that HIV might have been transmitted to Kebede from his mother. Hence, you should advise the grandmother to take Kebede to a nearby health centre or hospital for management of the diarrhoea and early infant diagnosis of HIV infection. You should provide her with oral rehydration salts (ORS) and tell her how to give it to the infant until he arrives at the health centre. Remember that she should continue feeding him with locally available foods recommended for children with chronic diarrhoea.
- c.Screening Kebede’s siblings for HIV is also important to provide early care for them if they are HIV-infected.
Summary of Study Session 28