[Human immunodeficiency virus infection in children]

Four hundred to 600 pregnancies have now been carried to full-term by HIV seropositive women in France. The rate of transmission of the virus to the infant is around 20%, and there remains much uncertainty concerning the exact mechanism involved. Early diagnostic methods are based on isolating the virus in culture or PCR but the sensitivity of this test is only 50% at birth, although rising to nearly 100% by 6 months of age. In the infant, the main characteristic of the disease is the existence of a subgroup (comprising 15 to 20% of the patients) that develops AIDS early, in association with opportunistic infection and encephalopathy in the first months of life. Treatment choices remain very limited, with the hope of eventual prevention of maternal-fetal transmission. The gravity of the ensuing psychological and social problems calls for a multidisciplinary approach to the infant, family and relatives.