Children can take ARVs

Transcript

Thandeka Teyise asked Dr. Cotton when is the right time to start ARV treatment in children?

 DR COTTON:   Basically we don’€™t know there are no studies to address this question there are two approaches one is to treat young infants as soon as possible because we know that about 30 percent of them progress very rapidly. There’€™s another school of thought that feels that one should wait until symptoms and signs of HIV develop or your CD4 count drops below a threshold level.

THANDEKA: Ndimbuza umahluko phakathi komntwana nomntu omdala xa kujongwa izibalo zikagawulayo iCD4 cells count uthi kuxhomekeka kiwminyaka yokuzalwa kumntu nganmnye utsho esenza umzekelo nothi kumntu omdala lamanani ukuba angangamakhulu amahlanu lonto isancomisa kodwa uthi kwimveku eneenyanga ezintandathu lomanani ayakuba asezingeni eliphantsi kakhulu.

 DR COTTON:   I think this is a very important question and the main difference is that your absolute number of CD4 cells will vary with age. For   example in an adult a CD4 count of 500 is normal but for a six weeks infant is should be above 1500 and if it were 500 it would be extremely low.

   THANDEKA: Ndimbuzile ukuba kanye kanye ngumntu onjani ofumana unyango ngezithomalalisi kugawulayo uthi, ngezo zigulane zigulayo nabo baneempawu ezibonakalisa ukugula nabo baneeCD4 counts ezisezantsi.

 DR. COTTON: I think the sick patients definitely need ARVs, those that are symptomatic and those whose CD4 count percentages are declining rapidly or are quite low definitely need treatment.

 THANDEKA: Uthi okona kubalulekileyo kukuba kujongwe kakhulu kubantu abangabagcini nabancedi nabo nabathi babanike amachiza mihla le emisebenzini, esikolweni sonomngqusho, ezikolweni bevuka mihla le belungiselelela ukuphangela berhangqwe bubunzima bokunonophela ubomi babanye abantu.

DR. COTTON: I think that children can cope. What’€™s more important is can the caregiver cope? The person who is going to give the medication and giving the medication in to the daily life style, work, crèche, school getting up early for work coming home late, all the stresses caregivers might have.

 THANDEKA: Njengokuba sisazi abantwana ngabantu abasakhulayo nabafuna unonophelo nothando uGqirha Cotton uthi bayabajonga inkqubo yokukhula kwabo, bebajonga bechacha kakuhle bekhula nasekuboneni ubomi ngokubanzi nezinto ezikholisa bona njengabantwana. Uthi bahleli betsala negazi ukuqonda ukuba amachiza la ukuba akhuselekile yaye asetyenziswa ngendlela eyiyo na. Enye into athi bayayijonga yiCD4 count nokuba lamanani ayanyuka neyinto athi ibonakalisa ukuba noko imeko yomguli yencomisayo yaye nomzimba uwamnkele la machiza.

 DR. COTTON: We monitor the progress clinically, we watch them grow, we watch them get better become more interested in the world around them and become more interactive. We also do blood test at regular intervals to check up the medications are safe, and to check the CD4 count and if that goes up that’€™s an excellent sign of recovery by the body through the medications.

 THANDEKA: Uhambisa athi kunyaka wokuqala womntwana ongathabathi lamachiza malunga neepesenti ezingamashumi amathathu nangaphezulu sabantwana banokuqhuba kakuhle ngaphandle kwalamachiza yaye ngamanye amaxesha malunga nesihlanu seepesenti sabantwana minyaka le basenokuqhuba kakuhle ngaphandle kokusebenzisa lamachiza ixesha elide. Uthi sele ebone abantwana abasebuqina ngoku nabaqala besebancinane kakhulu ukuthathathabatha lamachiza sele benobomi obububo. Uthi likhona ithemba elililo ekwandisweni kobom ngalamachiza.

 DR. COTTON: Mhh! The life span differs; it depends on the availability of drugs but generally in the first year without the drugs about 30 percent of the children is going to progress very rapidly and in some areas even more. And then after that about 5 percent of them per year are going to progress rapidly, a small percentage of them are going to do very well without medication for a very, very long time. I’€™ve actually seen adolescents who’€™ve been on therapy since childhood who are normal interactive adolescents going to college, boyfriends girlfriends even having families. So I think there’€™s a reasonable chance of an extended life span.

There are problems people can forget to take medicine, I think all of us are forget to take medicine. The single most important issue with anti-retrovirals is that we cannot tolerate anything less than 100 percent compliance.

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