title: International perspectives, progress, and future challenges of paediatric HIV infection.
abstract: Paediatric HIV infection is a growing health challenge worldwide, with an estimated 1500 new infections every day. In developed countries, well established prevention programmes keep mother-to-child transmission rates at less than 2%. However, in developing countries, where transmission rates are 25-40%, interventions are available to only 5-10% of women. Children with untreated natural infection progress rapidly to disease, especially in resource-poor settings where mortality is greater than 50% by 2 years of age. As in adult infection, antiretroviral therapy has the potential to rewrite the natural history of HIV, but is accessible only to a small number of children needing therapy. We focus on the clinical and immunological features of HIV that are specific to paediatric infection, and the formidable challenges ahead to ensure that all children worldwide have access to interventions that have proved successful in developed countries.
authors.affiliation: Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford OX1 3SY, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Prendergast
authors.forename: Gareth
authors.initials: G
authors.lastname: Tudor-Williams
authors.forename: Prakash
authors.initials: P
authors.lastname: Jeena
authors.forename: Sandra
authors.initials: S
authors.lastname: Burchett
authors.forename: Philip
authors.initials: P
authors.lastname: Goulder
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002675:Child, Preschool; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010372:Pediatrics