James Reilly M.D. 
Article Title
Worries about HIV in orphans 
Posted Date

This question is not so simple as it would appear. First we never say whether someone should or should not adopt someone, because children can be adopted with HIV infection to avail the child of the myriad opportunities for treatment that are available in the United States. HIV is an infection caused by a virus which is known to be transmitted from mother to child.

The transmission of the virus can be decreased from approximately 30 percent to eight percent with the perinatal treatment with antiretrovirals. The HIV antibody test can be positive in an infant just because they are the infant of an infected mother and the antibodies are able to cross the placenta. If the mother has antibodies then the child could have antibodies. What was the medical condition of the mother? This could effect the way that we interpret these results. This child is reported to be "negative" at birth although at birth tests such as PCR, HIV culture, detection of HIV RNA or detection of p24 antigen are usually done because of what we previously stated. A child over the age of 6 months we can follow the HIV antibodies because they start to wane.

A child is considered negative if two consecutive HIV antibody tests are negative and the child has no other clinical or immunologic abnormalities. This of course assumes that the tests are being done correctly. It is recommended that all children who come to the United States be screened for HIV at least once. The good news is that in recent studies that children from international adoptions seem not to be initially negative and then become positive. This is something that we always worry about but, our experience with this issue is very positive.

The other part of this question is that we know about the HIV infection but are there any other infections that could have been transmitted to the child by the mother. Hepatitis C,B, and syphilis should be tested. These infections should be checked in all international adoptees but information about the mother could effect the way we investigate a child. As usual the lack of information puts us at risk because we cannot say anything with a great degree of certainty.

Ideally another test could be done and sent to an American reference laboratory for the appropriate testing if this is something that is considered to be vitally important. Note: The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem.

If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This website does not constitute a physician patient relationship.

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