Transmission, diagnosis, and treatment of HIV infection in children.

AIDS is one of the leading causes of death in children. Although children of all ethnic groups are affected, there is an overrepresentation of cases among minority children. Most cases of pediatric HIV infection are acquired by vertical transmission of infection from mother to infant. Factors that appear to increase the risk of vertical transmission include an advanced stage of maternal disease and absence of maternal gp120 antibody. Progression of the disease is more rapid in vertically infected children than in adults. In children older than 15 months of age, as in adults, diagnosis of infection is usually made when HIV antibody is detected in the serum. In children younger than 15 months, this is not reliable because the presence of maternal antibody can result in a positive antibody test. While pharmacotherapy for pediatric AIDS patients is similar to that for adults, care must be taken when considering dosage and route of administration.