HIV In Infants and Children

HIV/AIDS Awareness ribbons against a black background

HIV Infection in Infants and Children

National Institute of Allergy and Infectious Diseases (NIAID) has a lead
role in research devoted to children infected with HIV (human
immunodeficiency virus), the virus that causes AIDS (acquired
immunodeficiency syndrome). NIAID-supported researchers are developing
and refining treatments to prolong the survival and improve the quality
of life of HIV-infected infants and children through the Pediatric AIDS
Clinical Trials Group (PACTG). The PACTG is a nationwide clinical trials
network jointly sponsored by NIAID and the National Institute of Child
Health and Human Development (NICHD). NIAID also supports research on
ways to prevent mother-to-child transmission (MTCT) of HIV through the
PACTG and its HIV Prevention Trials Network (HPTN), a global clinical
trials network designed to test promising nonvaccine strategies to
prevent the spread of HIV/AIDS.

In this era of antiretroviral therapy, epidemiologic studies such as
NIAID’s Women and Infant’s Transmission Study (WITS) are examining risk
factors for transmission as well as the course of HIV disease in
pregnant women and their babies. Researchers have helped illuminate the
mechanisms of HIV transmission, the distinct features of pediatric HIV
infection, and how the course of disease and the usefulness of therapies
can differ in children and adults.


According to UNAIDS (The Joint United
Nations Programme on HIV/AIDS) at the end of 2003, an estimated 2.5
million children worldwide under age 15 were living with HIV/AIDS.
Approximately 500,000 children under 15 had died from the virus or
associated causes in that year alone. As HIV infection rates rise in the
general population, new infections are increasingly concentrating in
younger age groups.

December 2003 UNAIDS/World Health Organization (WHO) worldwide statistics show

  • 700,000 children under age 15 were newly infected with HIV
  • Thirteen percent of all new HIV infections were in children under age 15
  • Three million children in sub-Saharan Africa, the region with the highest number of cases, are living with HIV

More than 95 percent of all HIV-infected people now live in
developing countries, which have also suffered 95 percent of all deaths
from AIDS. In those countries with the highest prevalence, UNAIDS
predicts that, between 2000 and 2020, 68 million people will die
prematurely as a result of AIDS. In seven sub-Saharan African countries,
mortality due to HIV/AIDS in children under age five has increased by
20 to 40 percent. Life expectancy for a child born in Botswana, the
country with the highest HIV prevalence in the world, has dropped below
40 years-a level not seen in that country since before 1950.

The United States has a relatively small percentage of the
world’s children living with HIV/AIDS. From the beginning of the
epidemic through the end of 2002, 9,300 American children under age 13
had been reported to the Centers for Disease Control and Prevention
(CDC) as living with HIV/AIDS. The vast majority of HIV-infected
children acquire the virus from their mothers before or during birth or
through breast feeding. Because of the widespread use of AZT and other
highly active antiretroviral therapy (HAART) in HIV-infected pregnant
women in the United States, only 92 new cases of pediatric AIDS were
reported in 2002. More than three times that number are infected with
HIV but have not yet developed AIDS.