HIV Infection Complications during Childhood

Abstract

According to the World Health Organization (WHO), about 2.1 million children under the age of 15 were infected with the Human Immunodeficiency Virus (HIV) in 2015. The introduction of combined antiretroviral therapy (CART) has changed the natural history of Patients infected with HIV. Chronic diseases associated with HIV infection have taken a more prominent role in relation to acute infections. This literature review aims to systematize the complications associated with HIV infection in the pediatric age (defined by the WHO as that between birth and 19 years) in two large groups: infectious diseases and non-infectious diseases. In the group of infectious diseases, it is intended to emphasize the most prevalent infections in the pediatric age, while in the group of non-infectious diseases we aim to present the main complications by organs and systems. The search engine used to conduct the search was the PubMed and The Pediatric Infectious Disease Journal. In this paper, HIV infection is treated as a systemic infection, with the direct consequences of infection per se and the indirect consequences associated with the introduction of CART. The main complications are infectious, mucocutaneous, cardiovascular, respiratory, neurological, nephrological, gastrointestinal, otorhinolaryngological, ophthalmologic, endocrinological and neoplastic, as well as immune reconstitution syndrome associated with CART. In conclusion, the pediatric complications associated with HIV infection vary with the immunosuppression state, the transmission route, the age at infection contraction and at the introduction of CAR and the geographical location of the infected children. CART decreased the incidence of opportunistic infections and neoplasms, but paradoxically is associated with an increased incidence of immune reconstitution syndrome, cardiovascular diseases, metabolic syndrome and lipodystrophy. Early detection of complications improves the quality of life of the pediatric population. Thus, the research and training of health professionals who accompany them is crucial.