Pediatric human immunodeficiency virus infection.
In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies.
Pediatric Infectious Disease, State University of New York Health Science Center, Syracuse 13210, USA. jdomach@helix.nih.gov
J B
JB
Domachowske
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology; D016049:Didanosine / Q000627:therapeutic use; D018562:Disease Transmission, Infectious; D005128:Eye Diseases / Q000821:virology; D005260:Female; D005767:Gastrointestinal Diseases / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006331:Heart Diseases / Q000821:virology; D006402:Hematologic Diseases / Q000821:virology; D006561:Herpes Simplex / Q000150:complications / Q000453:epidemiology; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007674:Kidney Diseases / Q000821:virology; D008297:Male; D009369:Neoplasms / Q000821:virology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012871:Skin Diseases / Q000821:virology; D065227:Transfusion Reaction; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine; D016049:Didanosine