Understanding HIV in Children: Epidemiology, Clinical Manifestations, and Current Therapeutic Strategies

Abstract: This review provides a comprehensive overview of Human Immunodeficiency Virus (HIV) infection in children, detailing its etiology, epidemiology, clinical manifestations, diagnosis, and management. Primarily, pediatric HIV is acquired through mother-to-child transmission, with additional transmission routes including sexual abuse and contaminated blood products. While significant progress in reducing mother-to-child transmission has been achieved in regions like the United States, a substantial burden of HIV in children persists globally, particularly in sub-Saharan Africa, where unique transmission patterns are observed. The article outlines the varied symptoms of paediatric HIV, often appearing as slowed growth, recurrent bacterial infections, organ enlargement, and critical opportunistic infections like Pneumocystis jirovecii pneumonia, alongside neurodevelopmental complications. Diagnosing HIV in children, especially infants under 18 months, presents unique challenges due to passively acquired maternal antibodies, necessitating reliable virological tests. For older children, serological antibody tests are employed, followed by confirmatory assays. Effective management involves early initiation of Antiretroviral Therapy (ART), rigorous monitoring of viral load and CD4+ T-cell counts, and strategies to ensure optimal treatment adherence, which is particularly challenging in adolescents. The review also highlights the crucial role of multidisciplinary care, including physiotherapy, in managing disease complications. Ultimately, this synthesis underscores the ongoing global imperative for robust prevention, early diagnosis, and consistent treatment to mitigate the profound impact of HIV on children’s health and well-being.