Progress and challenges in antiretroviral therapy for HIV-infected children

The treatment and prognosis of pediatric HIV infection in the developed world has been transformed with the introduction of highly active antiretroviral therapy. Perinatally infected children are now living into adulthood, changing the face of this epidemic from one of pessimism to one of hope. However, this transformation has brought with it many unforeseen challenges. In this review, we attempt to highlight key issues in the management of HIV-infected children, such as adherence, treatment strategies, drug resistance, and toxicities. We trust that the experience that we have accumulated can be successfully implemented in countries where treatment is urgently needed.