As it is difficult to ascertain the diagnosis and management of the HIV-positive child because of the lack of data from trials, some management policies will have to be estimated from findings in adults until trials in children are completed. Also, the difficulty in determining HIV serologic status in infants born to infected mothers makes the matter more complex. In children with HIV infection, Pneumocystis carinii pneumonia develops most commonly at age 3-6 months and carries a high mortality rate. It is advised by Dr. Diana Gibbs and Dr. Sam Walters that trimethoprim-sulphamethoxzole be administered to children of uncertain HIV-infection status from age 3 weeks. The doctors have devised guidelines addressing the management of HIV-infected children and related complications, and taking into account factors like regular childhood immunization, screening, confidentiality, and service issues. The guidelines will be routinely updated. Pediatricians who would like to get involved in the multicenter European clinical trials that evaluate treatments in HIV-positive children can receive details from Dr. Gibbs at the Institute of Child Health.

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