HIV, AIDS
(Human immuno-deficiency virus)

Description
HIV is a virus carried in blood and body fluids. It damages the immune system of the person infected to the extent that the person becomes susceptible to a variety of common and rare diseases. HIV infection is called AIDS when it becomes fully developed in the body. People with AIDS contract repeated infections with unusual organisms and cancers that do not normally affect people with healthy immune systems. Transmission How HIV is spread • Sexual intercourse (anal or vaginal) with an infected person. • Sharing of infected needles and syringes. • Infected mother to child just before or during birth, or through breastmilk. Between 25% and 50% of children born to infected mothers will themselves become infected due to transmission of HIV before, during, or soon after birth. In a small number of cases, the disease is transmitted to the child through the mother's breastmilk. • Penetration of the skin by infected blood. • There is no evidence that HIV is spread from child to child in schools or child care centres through normal social contact. • HIV is not transmitted through air or water, the sharing of plates, cups or cutlery, swimming pools or toilets, kissing, coughing, sneezing or spitting. There is no evidence that HIV can be spread by mosquitoes or other biting insects, as the virus dies rapidly outside the human body.


Incubation Period
The disease may not be evident for months or even years after HIV infection. In adults, a glandular fever-like illness occurs a month or so after infection in about 50% of people. HIV infection develops into AIDS within 10 years in at least 40-50% of infected people.


Infectious Period
People become infectious about 2-4 weeks after picking up the HIV virus. A blood test for antibodies to the virus will show whether a person has been in contact with and become infected by the HIV virus. It seems likely that HIV infection may be lifelong, and that people infected with HIV will always be potentially infectious. However, the spread of the infection to others requires special and unusual conditions. To date, there have been no reported cases of infection with the virus through ordinary social contact, through involvement with schools, pre-schools or child care centres, or through ordinary non¬sexual family contact.


Controlling the Spread of Infection
We recommend that children who have been infected with the HIV virus and who are apparently healthy do not need to be excluded from the child care centre, provided normally acceptable levels of cleanliness and supervision are maintained. Children who are unwell should be assessed by their doctor before any decision is made about whether they should stay away from school until better. Children who have moist skin lesions or abrasions should cover those lesions while at school. The covering should be waterproof (so that body fluids cannot leak) and they should be securely attached. If lesions are weeping or discharging and cannot be covered, then as a precaution the children should remain away from school until their lesions have healed or can be covered. Children who have significant behavioural disturbances may need to be excluded from school depending on advice from the child's doctor in consultation with public health staff, the child's parents or guardians, and child care or educational staff. Children who have developed impairment of immunity should remain away from school during outbreaks of serious contagious diseases such as measles or chickenpox. Children with HIV are more susceptible to such infections. In schools, pre-schools and child care centres and in ordinary social contact, there is no need to segregate items used regularly by all children, such as eating utensils, plates and cups. Washing them in warm soapy water is all that is required. The usual cleaning techniques are sufficient for toileting and washing facilities. Care should be taken when exposure to blood or body fluids of any type occurs. Refer to the section on dealing with blood and body fluids on pages 18-19. In the unlikely event of having to resuscitate a child infected with HIV, take simple precautions if time and facilities allow. These include the use of mechanical ventilators and disposable or sterilisable mouth¬to-mouth masks, if available. The risk of infection through direct mouth-to-mouth contact is extremely low. Never withhold resuscitation. All centres caring for children should ensure that they have a well¬equipped first aid kit and know how to use it effectively. Personnel policies Child care workers and staff members who are infected with HIV (or who think they might be) do not have to inform their employer that they have HIV. However, they do have a duty to act in a responsible manner towards others. In view of the potential for these people to become ill with AIDS, they should seek medical assistance in monitoring their own health. They should also be particularly aware of the dangers to others of accidental transmission of the disease. They must prevent their blood and body fluids coming into physical contact with others. The symptoms and effects of the disease are such that staff may be unable to continue work or may require intermittent sick leave. As in the case of other illnesses, the employer should ensure that the staff member is acquainted with sick leave entitlements.


Treatment
For patients with clinical AIDS, medical practitioners use specific drugs (for example, antibiotics and anti-viral drugs) to overcome secondary infections associated with the disease. Drugs that interfere with the replication of HIV are available. These drugs do not cure AIDS. An enormous worldwide effort is being made to educate people about AIDS, to reduce the spread of HIV, to search for new anti-viral drugs effective against HIV, and to develop a vaccine. Australian authorities are monitoring these developments closely.


Comments
The information in this section has been drawn from several publications: 'Paediatric AIDS' in AIDS Task Force Bulletin 3 / 86 'Children and AIDS' in AIDS Task Force Bulletin 4 / 86 HIVIAIDS and the Workplace: Information for Health Workers and Others at Risk in Worksafe Australia booklet

Disclaimer
The information contained in this website is intended as a guide only. Wollongong Medical Centre is not liable for any problems that may arise from incorrectly or otherwise applying information found in this website.


Further General Information

The following web site has information on infectious diseases: www.health.nsw.gov.au/infect/ or contact the Division of Population and Planning on 4255-2200.

For information on a large range of medical conditions and problems visit www.mayoclinic.com