PEDIATRIC HIV-INFECTION IN THE REPUBLIC-OF-IRELAND AND THE NEED FOR ANTENATAL SCREENING

Thirty-seven HIV-infected children have been identified in the Republi c of Ireland since 1985. Only 12 (32%) of 37 were followed prospective ly from birth. Median age at diagnosis was 18 months (4 weeks to 8 yea rs). In 32 (86%) of 37 cases, HIV infection was acquired as a result o f transmission from mother to infant with intravenous drug use (IVDU) the most frequent risk factor for maternal acquisition of HIV. Of thes e 32 children, median maternal age at delivery was 24 (interquartile r ange (IQR) 23-26) years with median gestation at delivery 40 (IQR 38-4 0) weeks. Mode of delivery was by vaginal delivery in all 29 (91%) cas es where mode of delivery is known. Only 2 infants were breastfed. Sev en children have died at a median age of 9 (0.8-9.6) years. As of July 1997, 12 children have AIDS, 14 have symptomatic disease without AIDS and 3 are asymptomatic. Median age at AIDS diagnosis was 2.6 (0.1-6.5 ) years. Median survival time post-AIDS diagnosis was 6.5 (1.8-8.3) ye ar s. Of 29 living children, 24 mothers and 14 fathers are HIV infecte d and only 14 children live with both parents. Childhood HIV infection has had a significant personal, social and financial impact on both I rish families and society in general. More effective measures to contr ol HIV infection among intravenous drug users are needed. Antenatal de tection of HIV-infected mothers is paramount as vertical transmission can be successfully prevented and morbidity and death can be prevented in the infected infant.