HIV infection in children

: More children will be born infected with HIV in the years to come. Children with early symptoms will come into quick contact with a hospital, while others may be infected for up to ten years without presenting HIV-related symptoms. HIV infection can be diagnosed early with a combination of methods that are currently available (viral culture, ELISA antigen testing), and also with methods that are at present only used in research (DNA and RNA detection with PCR). Together with the clinical picture, it should be possible to have a reliable diagnosis no later than six months after birth. The general development of the children can be followed at frequent out-patient visits, while prophylactic measures can quickly be put into motion when necessary. The course of the illness can be followed and predicted with the help of different laboratory investigations. The medical treatment of HIV positive children follows the pattern of adult HIV positive patients. Children with an increased risk of bacterial infections can receive intravenous immune globulin as prophylaxis. HIV infected children can be given the common vaccinations, but BCG and oral anti-polio vaccine should not be given to children with symptomatic HIV infection. Prophylaxis of vertical transmission of HIV should be aimed at HIV testing of all pregnant women, to prevent this route of transmission. As long as there is no efficient treatment of HIV infection, termination of pregnancy must be recommended early after conception to all HIV positive women. Children born of HIV positive mothers should not be breast-fed.