Wednesday 7 January 2009

Sweet food of sweetly uttered knowledge

How do we know if the babies of HIV-positive mums are infected? Clearly the head of the Sukabumi municipal health service (Dinas Kesehatan), Boyke Priyono, is not clear. He should be aware that the normal HIV test, which looks for antibodies, may give a positive result in such babies up to the age of 18 months. This is because babies are bequeathed all of their mother's antibodies at birth. It may take a year and a half to lose these antibodies, and replace them by it's own ones - if they are indeed infected. So a positive result prior to this is not conclusive.

There is an alternative, using a test which looks for bits of the virus, not the antibodies. This test can give a confirmed result at around six weeks of age, but as I related previously, it costs a bomb (at least for most families) and is not widely available in Indonesia. I'm sure it's rarely, if ever, used in Sukabumi.

Yet Pak Boyke is reported in today's Kompas daily as saying that they identified four babies with HIV in the town last year. "They were confirmed HIV-positive after being tested at the age of one year," he is reported as saying.

In shades of the infamous former South African Health Minister, he is also reported as saying that the babies immune system must be preserved with good nutrition. "If not, they will progress to AIDS more quickly. With control of their development and good nutrition, they will probably only progress to AIDS in adolescence."

Of course, if they are not actually infected, it may take even longer, dependent upon whether/when they join in the normal risk behaviour of adolescents here. But Pak Boyke should be aware that, if they were infected at birth, even with the best possible nutrition (beetroot anyone?), they will almost certainly need antiretrovirals before the age of ten.

One wonders what the parents of these kids have been told?

Babé

No comments: