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Human Immunodeficiency Virus (HIV) Infection in Children

By The Manual's Editorial Staff,

What is HIV?

Human immunodeficiency virus (HIV) is a virus that affects the body's immune system. "Immunodeficiency" means the immune system is weak. The body is thus less able to defend itself from certain infections and cancers. That means someone with HIV is more likely to get sick with other infections and illnesses.

  • Young children who have HIV usually got the virus from their mother at birth

  • Doctors do blood tests to diagnose HIV

  • Without treatment, children with HIV can get AIDS (acquired immunodeficiency syndrome)

  • There's no cure for HIV, but medicines slow down the virus a lot

  • Children who get medicines for HIV (called antiretroviral therapy or ART) can live into adulthood

  • Mothers with HIV can usually prevent their babies from getting HIV by taking ART during pregnancy and birth and giving the baby ART medicine after birth

What is AIDS?

AIDS is acquired immunodeficiency syndrome. It's the most severe form of HIV infection. The immune system gets even weaker and can't fight off infections. People with AIDS can get unusual infections that almost never affect people without AIDS.

HIV infection is considered to be AIDS when:

  • The child has a serious infection that children without HIV almost never get

  • Blood tests show a very weakened immune system

Children who take their HIV medicine regularly almost never get AIDS.

How do children get HIV?

Young children with HIV almost always got the virus from their HIV-infected mother before or during birth. Because the virus is in breast milk, breastfeeding can transmit the virus.

Older children and teens can be infected by:

  • Having sex with someone who has HIV

  • Being exposed to blood from someone with HIV

  • Sharing needles used by someone with HIV

Because blood donations are tested for HIV, almost no infections happen from blood transfusion in the US, Canada, or Western Europe.

HIV is not spread by:

  • Food

  • Water

  • Touching or sharing household items

  • Touching, kissing, or being around an infected person at home, work, or school

What are the symptoms of HIV in children?

Children with HIV infection seem healthy at first. As time goes on, they have more frequent and more severe common problems such as colds, ear infections, and diarrhea. Symptoms depend on whether the child is being treated with medicines for HIV. Medicines for HIV are called ART (antiretroviral therapy).

If children aren't treated with ART, they can have:

  • Slower growth and slower development (for example, not learning to walk or talk, or learning later than usual)

  • Swollen lymph nodes

  • Diarrhea that doesn't go away

  • Anemia (a low number of red blood cells)

  • Swelling of their spleen or liver

  • Frequent fungal infections of their mouth (thrush)

  • Other infections

  • Weight loss

Children who don't get ART eventually develop AIDS.

If children are treated with ART, they can have:

  • No symptoms at all

  • Frequent bacterial infections, such as ear infections

  • Behavior and learning problems—though it's not clear if these are because of HIV infection, taking certain medicines, or other reasons

Children with treated HIV infection can have long-term problems as they get older such as:

How can doctors tell if a child has HIV?

Doctors test the blood for HIV in babies and young children if their mother has HIV or is at risk of having HIV. Doctors recommend all pregnant women be tested for HIV.

Babies are tested at birth. But babies born to HIV-infected mothers need several more blood tests over the next 6 months just to be sure they don't have HIV.

How do doctors treat HIV in children?

Doctors treat children with HIV using:

  • Antiretroviral therapy (ART)

  • Sometimes antibiotics to prevent certain infections

ART always uses more than one medicine. Children with HIV usually take 3 different medicines. For older children, the medicines are sometimes combined into one pill. It is very important the medicine is taken regularly at the right time and in the right amount. If children take the medicine less often, the HIV can become resistant to the medicine. Resistant means the medicine will no longer work against the HIV. If the HIV becomes resistant to one medicine, doctors will try a different medicine.

Doctors do blood tests about every 3 to 4 months to measure:

  • The number of white blood cells

  • The amount of HIV virus in the blood

These blood tests help the doctor know if treatment is working. Doctors also do tests to see if the virus is becoming resistant to medicines and to check for side effects of the medicines.

Almost all children with HIV should get their regular childhood vaccines.

Children with HIV should join in as many normal childhood activities as their health allows. It's very unlikely they could spread HIV to other children.

How can I prevent my child from getting HIV?

If you're pregnant and have HIV, you can lower the chance of spreading the infection to your baby by:

  • Taking ART (antiretroviral) pills, particularly during the 2nd and 3rd trimesters (last 6 months) of pregnancy

  • Continuing to take ART medicines regularly if you already take them

  • Getting specific ART medicine by IV during labor and delivery—this medicine is also given to your baby for 6 weeks after birth and lowers the chance your baby will get HIV

  • Having a C-section instead of a vaginal delivery, if you have a lot of HIV virus in your blood

  • Using formula instead of breast milk to feed your baby, unless you live if you live in a place where water isn't safe for making formula

Check to see if your child's day care center or school has a safety plan for cleaning up blood that includes:

  • Wearing latex gloves

  • Washing hands after taking the gloves off

  • Cleaning and disinfecting any surfaces that have had blood on them with a solution of 1 part bleach to 100 parts water

  • Avoiding touching the blood

These universal precautions should be used with all children since staff or parents may not know whether a child has HIV infection. These precautions should also be followed at home if any family member has HIV.