Primary opportunistic infections are often seen in children, whereas a reactivation of latent microorganisms is common in adults. Besides opportunistic MAPK inhibitor infections, severe and recurrent common

pneumococcal infections (pneumonia, otitis media, sepsis, meningitis, etc.) often occur at the onset of AIDS in children. Nervous system abnormalities and effects on general growth also occur. Tests for the diagnosis of HIV infections are usually performed by serological assays such as the enzyme immunoassay in pregnant women and children. Because the serological assay can result in false positivity, the results must be confirmed by Western blotting. Diagnostic tests are recommended in sexually active patients who have an influenza-like illness or infectious mononucleosis-like symptoms, as well as those with opportunistic infections such as herpes zoster and oral candidiasis. The window period (6 weeks from the time of infection) must also be considered. Although HIV-2 infection is rare in Japan, the screening test is also useful for detecting HIV-2 infections. Because there is a possibility of false positivity due to maternal antibodies in cases of MTCT, serological assays BIBW2992 are not suitable for diagnosis until the child is 18 months of age. If an infant is more than 6 months of age, MTCT can be ruled out if the presence of antibodies is negative in 2 tests performed more than 1 month apart, and if there is no sign of infection. After giving

birth, diagnosis of the carrier mother is usually performed using PCR. At 4 time points, namely, 48 h, 14–21 days, 1–2 months, and 4–6 months after delivery, PCR analysis is performed, and if the results are positive, they are confirmed by a second PCR analysis [12]. In infected babies, the plasma viral load is measured by quantitative HIV-1 RNA-PCR and CD4+ T-cell counts that are measured monthly before 12 months of age and every 3 months

after 1 year of age. The CD4+ T cell count represents the level of progression whereas the plasma RNA level represents the speed of progression [13]. Children are infected find more at a high rate (more than 25%) from carrier pregnant mothers who do not take adequate precautions, and therefore, the prevention of MTCT is very important [14]. The 4 major key points for the prevention of MTCT are the following. First, reducing maternal viral load by ART. Second, avoiding exposure to maternal blood upon vaginal delivery or during selective cesarean section. Third, eliminating HIV in the child by ART. Fourth, refraining from breast feeding to prevent infection through breast milk. Oral administration of ZDV (600 mg/day) or multiple drug combination therapy (highly active ART: HAART) is recommended in pregnant women after 14 weeks of gestation. Additionally, Retrovir should be administered intravenously during the entire period of labor [15]. For newborns, ZDV should be administered as an oral syrup (8 mg/kg/day, 4 qds) or intravenously (1.5 mg/kg every 6 h) until 6 weeks after birth.