Answers to the most frequently asked questions about pediatric HIV and AIDS.

What is HIV?

The human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). HIV can be transmitted during sexual intercourse, pregnancy (i.e., from mother to fetus), childbirth, breastfeeding, and other forms of exposure to bodily fluids that carry the virus. When the virus enters the body, it injects itself into vital immune cells called CD4 cells. In the absence of treatment, HIV continues to replicate itself within the body, eventually leading to severe immunodeficiency, chronic illness, and death.

What is AIDS?

AIDS represents an advanced stage of HIV infection. In most cases, a person living with HIV eventually develops AIDS. AIDS is characterized by severely diminished immune system function, where the body is highly vulnerable to infections and cancers that are typically fought off by a healthy immune system. As defined by the U.S. Centers for Disease Control and Prevention, a person has AIDS when HIV has drastically reduced his or her CD4 cell count, or when a person living with HIV is diagnosed with at least one opportunistic infection (i.e., an infection that does not normally occur in someone with a healthy immune system).

How many children are living with HIV?

As of 2018, of the estimated nearly 38 million people worldwide living with HIV, approximately 1.7 million are children under 15 years of age. Since 2010, new HIV infections among children have declined by 41%, but only half (54%) of all children living with HIV are getting treatment and 100,000 children died of AIDS-related illnesses in 2018 (UNAIDS, Global AIDS Update, 2019).  About 500 children are newly infected with HIV every day.

How do children become infected with HIV?

More than 90 percent of HIV infections in children result from mother-to-child-transmission, where the virus is passed from a mother living with HIV to her baby during pregnancy, childbirth, or breastfeeding. The risk of this form of transmission increases in direct relation to the severity of the mother’s HIV infection.

How does HIV affect children?

Because children’s immune systems are not fully developed, children living with HIV get sick more severely than adults. They may experience the same common pediatric infections as HIV-negative children, but cannot fight these infections as effectively. Common infections in HIV-positive children include ear and sinus infections, sepsis, pneumonias, tuberculosis, urinary tract infections, intestinal illness, skin disease, and meningitis. In developing countries in particular, tuberculosis, diarrhea, and respiratory illnesses are common in HIV-positive children.

How can HIV infection in children be prevented?

The most effective method for preventing mother-to-child transmission (PMTCT) of HIV is by initiating HIV-positive pregnant women on antiretroviral therapy (ART) as early as possible. ART decreases viral levels in the mother’s bloodstream, thus reducing the risk that she will transmit the infection to her infant. ART should also be administered to a child before and after birth; treatment will help a baby’s body resist infection.

Globally, an estimated 82% of pregnant or breastfeeding women living with HIV were receiving antiretroviral medicines to prevent transmission of HIV to their children in 2018. (UNAIDS, Global AIDS Update, 2019)

How is HIV infection in children treated?

There is no cure for HIV infection. Early infant diagnosis is critical, however. When ART is administered as early as possible in the course of infection, it can help children living with HIV lead longer, healthier lives. Taken every day, these medicines can drastically reduce the concentration of HIV in the bloodstream and increase levels of CD4 cells, thereby slowing the progression of the disease.

Sadly, most children still do not have access to ART. Without diagnosis and treatment, one-third of infected infants will die before the age of one, and almost one-half before their second birthday.