In 2014 it was estimated that, worldwide, some 2.6 million children aged less than 15 years were had the human immunodeficiency virus (HIV), of whom 88% were in sub–Saharan Africa. In the same year, approximately 240 000 more children were diagnosed, primarily through mother-to-child transmission.
The effect of HIV in children
As children’s immune systems are not fully developed, children with HIV can become more acutely unwell than adults. Children with HIV are less able to fight off common childhood illnesses than children without HIV, meaning they may become sicker, develop more serious sequelae or fatal consequences. Common problems seen in HIV-positive children include pneumonia, tuberculosis, meningitis and skin infections while diarrhoeal disease in developing countries remains a killer in children.
The most effective strategy in paediatric HIV is in prevention – particularly mother-to-child transmission of the virus, through effective pregnancy management.
Australian models of care
HIV in children is a highly specialised branch of HIV care and the number of children in Australia with HIV is fortunately very low. HIV positive children may only come to the attention of mainstream HIV services around adolescence when it is time to transition to adult services.
Children’s HIV care is managed primarily through Paediatric HIV Specialist Services in each state and territory e.g. The Royal Children’s Hospital in Melbourne or The Sydney Children’s Hospital Network, Randwick.
Early diagnosis of HIV remains critical, as early treatment will lead to better outcomes for children, with preservation of good immune function. Without diagnosis and effective management with antiviral medication, about one third of children with HIV infection will die before they reach 12 months of age.