Medical expert of the article
New publications
HIV infection and AIDS in children
Last reviewed: 12.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
HIV infection, AIDS - a viral disease of the immune system, leading to a sharp decrease in the body's overall resistance to opportunistic microorganisms, as well as an increased susceptibility to cancer, which is why the disease has a severe course with an inevitable fatal outcome.
HIV infection is a long-term infectious disease caused by the human immunodeficiency virus (HIV), which affects cells of the immune, nervous and other systems and organs of a person. With HIV infection, the immune system is damaged, leading to the development of acquired immunodeficiency syndrome (AIDS).
HIV infection was identified in 1981, when the Centers for Disease Control and Prevention (CDC) reported 5 cases of Pneumocystis pneumonia and 28 cases of Kaposi's sarcoma in previously healthy homosexuals. Immunological testing of these patients revealed a sharp decrease in the level of CD4 lymphocytes. The diagnosis was first formulated: Acquired Immunodeficiency Syndrome (AIDS).
[ Epidemiology of HIV infection in children
HIV infection is found on all continents and in almost all countries where a systematic search for patients is conducted. According to WHO, about 50 million people live with HIV infection. More than 2 million people with HIV infection are identified annually.
The age structure of those who fell ill, and especially those infected, has not been precisely determined. According to generalized data, the proportion of children among those who fell ill reaches 10% or more.
Causes of HIV infection in children
Pathogen. Human immunodeficiency virus (HIV) belongs to the family of retroviruses (Retroviridae). The family of retroviruses includes two subfamilies: oncoviruses (Oncoviridae) and slow lentiviruses (Lentivirus). The first subfamily includes viruses that cause leukemia: T-cell leukemia and chronic hairy cell leukemia, as well as bovine leukemia virus.
HIV belongs to the subfamily of lentiviruses. Currently, 7 types of lentiviruses are known, of which 6 are pathogenic for animals and only one (HIV) causes disease in humans.
Pathogenesis of HIV infection in children
Each type of virus affects a certain type of cell. The ability of a virus to penetrate a cell is determined by the presence of a receptor for a given virus on the target cell, as well as the ability of the virus genome to integrate into the cell genome. It is known that a cell can have receptors for different types of viruses, and receptors for a certain virus can be on cells of different types.
The receptor for HIV is the differentiation antigen CD4, as well as nonspecific components that do not depend on the presence of CD4. CD4 is a glycoprotein with a molecular weight of 55,000, similar in structure to certain sections of immunoglobulins. The gp 120 virus protein has a similar structure, which determines the ability of HIV to penetrate into a cell.
Symptoms of HIV infection in children
The incubation period is from 2 weeks to 2 months. The duration of the incubation period depends on the routes and nature of infection, the infectious dose, the age of the child and many other factors. In case of infection through blood transfusions, this period is short, and in case of sexual infection, it is longer. The duration of the incubation period is a relative concept, since each specific patient has different meanings for it. If we calculate the incubation period from the moment of infection to the appearance of the first signs of manifestation of opportunistic infections as a result of immune depression, then it averages about 2 years and can last more than 10 years (observation periods).
In fact, about half of those infected with HIV have an elevated body temperature within 2-4 weeks of infection, this increase continues for up to 2 weeks, the lymph nodes, liver and spleen enlarge. Tonsillitis is often detected. The resulting symptom complex is called "mononucleosis-like syndrome".
Where does it hurt?
Classification of HIV infection in children
WHO recommends distinguishing four stages of the disease:
- initial (acute);
- persistent generalized lymphadenopathy;
- AIDS-associated complex as preAIDS;
- full-blown AIDS.
In addition, recently it has been proposed to identify a 5th stage of the disease - AIDS dementia.
Diagnosis of HIV infection in children
Most children born to HIV-infected mothers have HIV antibodies (maternal) in their blood. In this regard, serological methods of diagnosing HIV infection based on the determination of IgG antibodies (ELISA) are not diagnostically significant until 18 months of life, when maternal antibodies are completely destroyed.
Own specific antibodies appear in a child in 90-95% of cases within 3 months after infection, in 5-9% - after 6 months and in 0.5% - later. In children over 18 months, detection of serological markers is considered diagnostic.
Routine serological examinations are performed at birth, 6; 12 and 18 months of life. Obtaining two or more negative results at least 1 month apart in a child without hypogammaglobulinemia aged 12 months or older indicates against HIV infection.
What do need to examine?
What tests are needed?
Who to contact?
Treatment of HIV infection in children
The goal of therapy for HIV infection is to prolong the patient's life as much as possible and maintain its quality. Life expectancy without treatment in children is less than 6 months in 30% of cases; with therapy, 75% of children survive up to 6 years and 50% - up to 9 years.
It is necessary to conduct complex, strictly individualized therapy of patients with HIV infection, with careful selection of antiretroviral drugs, timely treatment of secondary diseases. The treatment plan is built taking into account the stage of the pathological process and the age of the patients.
Treatment is carried out in three directions:
- influence on the virus with the help of antiretroviral drugs (etiotropic);
- chemoprophylaxis of opportunistic infections;
- treatment of secondary diseases.
Drugs
Prevention of HIV infection in children
The anti-epidemic regime for HIV infection is the same as for hepatitis B. In pediatrics, the system of preventive measures should be built taking into account the fact that children usually become infected with HIV in high-risk families (AIDS patients, drug addicts, bisexuals, etc.). In this regard, the main preventive measure can be considered the global fight for a healthy lifestyle, as well as educational activities to combat prostitution, drug addiction, sexual perversion, etc.
Prognosis for HIV infection in children
Very severe. In clinically expressed forms, the mortality rate is about 50%. From diagnosis to death, it takes from 2-3 months to 2 years or more. In no case are normal immune functions restored spontaneously or under the influence of treatment. Among patients identified before 1982, about 90% have died by now. However, recently there have been reports of a more favorable prognosis, especially in the case of HIV type 2 infection. Patients with Kaposi's sarcoma have a better prognosis than patients with opportunistic infections. It is believed that patients with Kaposi's sarcoma have less damage to the immune system.
Использованная литература