Pediatric HIV infections in developed countries: current situation and future challenges

In 2013, approximately 1500 HIV-infected children are followed in France. Antiretroviral therapy (ART) has greatly improved the survival of these children, whose long-term clinical outcomes are encouraging in high-resources countries. However, paediatricians continue to face difficulties for these children: missed opportunities for early HIV testing (especially in immigrant children born in Sub-Saharan African countries), high rates of virological failure in ART-experienced children, lack of studies evaluating the long-term toxicity of ART in perinatally-HIV-infected patients. Future challenges will imply to study to what extent very early ART in infants may alter the establishment of HIV infection and improve the long-term immunological and virological outcome of these children.