Managing the child infected with HIV.

Abstract

Care of the HIV-infected/exposed infant and child is both routine and challenging. Routine well child care and immunizations are an important part of maintaining and monitoring health status. Challenges arise in the management of acute illnesses and the numerous crises that are experienced by the family caring for that child. Therapy guidelines now provide a logical way in which to initiate antiretroviral treatment and PCP prophylaxis. In HIV-infected children with early disease, common pathogens initially predominate, and only in advanced immune suppression does care become complicated enough to require expert consultation. With increasing numbers of HIV-infected women, perinatally acquired infections in infants will become more common. Early testing and identification will increasingly be important as a way to impact on the significant morbidity and mortality seen in infants less than 6 months old. A caring, compassionate, and comprehensive approach to the care of HIV-infected infants and children results in increased survival and lengthening of disease-free time. Providing this vitally needed care is both satisfying and stimulating.