HIV infection

This chapter is on the human immunodeficiency virus (HIV) and the specific effects of the virus on children. The field of HIV is a rapidly changing one as new research reveals new information in many aspects including the pathogenesis, prevention and in the field of antiretroviral therapy. This chapter strives to provide the latest updates. The first part deals with the epidemiology, the structure and life cycle of the virus, the immunopathogenesis, modes of transmission and prevention thereof, and making the diagnosis of HIV in children. This is followed by the natural history of HIV infection, classification of HIV infection and immune status, and the clinical manifestations of the disease. The next section covers general management and antiretroviral therapy of the HIV-infected child and adolescent. The final section covers prevention including prevention of mother to child transmission and vaccines. In the field of paediatric antiretroviral therapy (ART), there are continually changing guidelines, as new formulations and new drugs and new fixed-dose combinations become available. It is recommended that readers refer to the WHO and national guidelines for the latest guidelines.