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Management of diarrhea in HIV-affected infants and children

Patricia B Pavlinac1, Kirkby D Tickell, Judd L Walson

  • 1University of Washington, Global Health, 325 Ninth Avenue, Box 359931, Seattle, WA 98104, USA.

Expert Review of Anti-Infective Therapy
|November 12, 2014
PubMed

Insights

Diarrhea is a major killer of young children, especially those affected by HIV. Management strategies must be updated to address the unique risks faced by HIV-infected and HIV-exposed uninfected children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Diarrhea remains a leading cause of mortality in children under five globally.
  • HIV-infected and HIV-exposed uninfected (HEU) children face a disproportionately high risk of severe diarrhea and death.
  • Existing international guidelines do not account for HIV status in diarrhea management.

Discussion:

  • Increased susceptibility in HIV-affected children is multifactorial, including immunosuppression and antimicrobial prophylaxis.
  • Proximity to individuals shedding pathogens may increase pathogen exposure.
  • Current management approaches may not adequately address the specific etiologies and consequences in this vulnerable population.

Key Insights:

  • HIV infection and exposure significantly elevate the risk of fatal diarrhea in young children.
  • Management strategies need to be tailored to the specific needs of HIV-affected children.
  • A multifactorial approach is required to reduce diarrhea mortality in high HIV prevalence settings.

Outlook:

  • Strengthening HIV testing and treatment programs is crucial.
  • Targeted water, sanitation, and hygiene (WASH) interventions for HIV-affected households are essential.
  • Revisiting empiric antimicrobial use for specific pathogens in HIV-infected and HEU children is recommended.

Keywords:
HIV exposureHIV infectionchildrendiarrheamanagement

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