CHILDREN WITH HIV FACE RISK OF NEGLECT

Against the backdrop of a dangerous rise in HIV and AIDS cases among
adults, the number of children under 15 carrying the deadly virus remains
relatively low. But AIDS experts say that due to a lack of medicines and no
unified state policy, HIV-infected children often find themselves in more
dire straits than adult patients.

"Adult patients can be treated with 16 medicines, while for children's
therapy only five or six medicines are available in Russia," said Yevgeny
Voronin, chief doctor of the St. Petersburg Infectious Diseases Hospital.

Together with other AIDS experts, Voronin attended a round-table discussion
on AIDS among children this week, in the run-up to the solemn holiday
commemorating AIDS victims to be marked on Sunday.

According to Health Ministry statistics, 832 children have been infected
with HIV and 102 of them have died since AIDS was first detected in Russia
in 1987. These children contracted the disease both from HIV-infected
mothers and through blood transfusions or injections with recycled syringes
in hospitals.

Voronin lamented that too many children with HIV fall through the
bureaucratic cracks because of the absence of a clear-cut state policy.

He recalled the 270 or so children infected with the human immunodeficiency
virus through injections with recycled syringes and catheters in hospitals
in the southern cities of Elista, Rostov and Volgograd in 1988 and 1989.

Only 155 of them are alive today, Voronin said, and 55 of them receive
regular treatment in the hospital he heads, where they travel with their
parents every three months for a two-week round of therapy.

But besides these 55 children, the clinic also permanently treats 40
HIV-infected youngsters abandoned by their parents at birth. The fate of
these children, who have no one to depend on but the state, is unclear,
Voronin said.

The cash-strapped Health Ministry, which allocates money for the treatment
of such children, must also provide them with some basic education allowing
them to function in society, as no other governmental agency will fund it.

Galina Pankova, head of the epidemiology department of the Moscow AIDS
Prevention Center, which treats 78 HIV-infected children, including 25
abandoned by their parents, said that even healthy children born to
HIV-infected parents have practically no chances of being adopted.

Prejudices against people with AIDS are still strong in Russia, Pankova
said, adding that even orphanage officials find ways not to accept children
born to HIV-infected mothers - even if they are confirmed healthy.

Voronin said HIV-infected mothers often give birth to healthy children, but
many doctors contribute to the growing rate of HIV infection among children
by refusing to do Cesarean sections, fearing infection themselves.

"Routine Cesarean sections reduce the risk of infecting the infant by 50
percent. Doctors need to be given general regulations from the health
authorities on how to handle such deliveries," Voronin said.

Pankova said her center now treats patients with Phosfazid, a Russian
modification of AZT, the world's most common AIDS drug. Phosfazid, licensed
by health authorities last year, has fewer side effects and remains in the
body longer than AZT.

Along with the statistics on children, health officials also released the
latest overall HIV and AIDS figures this week. Over 10,000 new cases of HIV
have been registered in the first three months of this year - as compared
to slightly more than 18,200 in all of 1999. Over 90 percent of those who
contracted the virus were intravenous drug users, Deputy Health Minister
Gennady Onishchenko said Monday.

The new cases bring the total number of HIV cases to 36,133, including 832
children, the ministry reported. Health officials warn that the actual
incidence rate of HIV may be 10 times higher, as the country still lacks
comprehensive diagnostic and treatment programs, and as the majority of
those with HIV don't know they have contracted the disease.

Moscow, Kaliningrad, Irkutsk, Krasnodar and Tver remain the most severely
affected regions and cities.