Children

Children and HIV

Most HIV-positive children under the age of 13 are infected during pregnancy, childbirth, or breastfeeding. Better treatment and prevention strategies have helped to lower HIV infection rates for children in the United States.

If your child has been diagnosed with HIV, or you are caring for a child with HIV, here are some things to remember:

• Antibody tests for HIV are not accurate for newborns because the results often reflect the mother’s antibodies to HIV. Those maternal antibodies can remain in an infant’s system up to 18 months.
• Typically, it takes 2-3 months for an accurate diagnosis of HIV in an infant. Most HIV tests look for antibodies to HIV, rather than the virus itself. HIV tests for infants use a technique that amplifies and detects small amounts of the actual virus in the baby’s blood.
• 20 % of children will acquire an opportunistic infection within their first year of life.
• Children with HIV may be slower to reach developmental milestones.
• Many children with HIV reach adolescence without issue, and maintain relatively intact immune systems.
• Children with HIV suffer the usual childhood infections more frequently and more severely than uninfected children. These infections can cause recurrent colds, fever, diarrhea, dehydration, fungal infections (including persistent diaper rash), pneumonia, seizures, and other problems that can cause nutritional problems and may result in extended hospital stays.
• Children can also be susceptible to the same opportunistic infections as adults. In addition, they are susceptible to a lung disease called lymphocytic interstitial pneumonitis (LIP), which is rarely seen in adults. This condition, like Pneumocystis pneumonia PCP, can make breathing progressively more difficult and often results in hospitalization.
• While principles for treating HIV are similar in adults and children, healthcare providers must also consider age-related differences in CD4 cell counts, and medication toxicities.
• Children often face other issues related to living with HIV disease, including, family issues, bullying and medication adherence. As children age into adolescence they may also begin to face issues regarding sex and physical appearance.

For more information, see NIH’s HIV Infection in Infants and Children.