Infections in the HIV-infected child

The HIV pandemic has given rise to a growing population of children at risk for infectious disease, particularly in the developing world where the majority of the estimated 2.5 million children living with human immunodeficiency virus (HIV) worldwide reside. This review will explore the opportunistic infections encountered in the HIV-infected child. Due to space constraints, only the commonest acquired immunodeficiency syndrome (AIDS)-defining infections, including mycobacterial, fungal, viral and parasitic diseases, will be discussed. The epidemiological, clinical and morphological features unique to the HIV-infected child will be highlighted, with special emphasis on the altered or unusual histopathological patterns that may be encountered and ancillary tests that may be valuable in confirming the diagnosis. Where applicable, the changing trends in the era of HAART, including immune reconstitution inflammatory syndrome (IRIS), will be addressed. Ultimately, we hope to arm the practising histopathologist with information that will facilitate the accurate and timely diagnosis of imminently treatable opportunistic infections in the HIV-positive child.