ADVANCES IN THE TREATMENT OF CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Over the past decade a number of significant advances have been made in the diagnosis and management of human immunodeficiency virus infection in children. Using virologic methods, it is now possible to make a specific diagnosis within the first few months after birth (more than 95% of infected children can be diagnosed by 3 to 6 months of age). In addition, a better understanding of the normal "development' of CD4 lymphocyte counts in infants and children has shown that these values are distinctly different than in adults and that values change with advancing age. This is important in monitoring human immunodeficiency virus-infected children and in determining thresholds for instituting intervention strategies. Human immunodeficiency virus infection in children is now a treatable disease. Two antiretroviral agents have been approved for use in pediatric patients and a host of studies are underway to investigate the optimal regimens of these agents and alternative new agents. Standard recommendations are in place for prevention of Pneumocystis carinii pneumonia, the most common and often fatal opportunistic infection in human immunodeficiency virus-infected children. Advances have been made in supportive care, including the prevention of bacterial infections in some categories of patients.