The currently available varicella vaccine is not approved for HIV infected children yet. However it is prudent to vaccinate the healthy VZV susceptible contacts to minimize household contact. Cytomegalovirus infection is usually asymptomatic, but may manifest as insterstial pneumonia, encephalitis, myelitis, hepatitis or chorioretinitis. Tables 5B and 6 lists the various opportunistic infections encountered in HIV infected children. Cough, fever, respiratory distress, hypoxia with absence of any adventious sounds on chest auscultation are the hallmark.
Diagnosis requires demonstration of the protozoa which often best collected via bronchoscopy.
Importance of PCP prophylaxis cannot be over emphasized, however break through infections do occur. 13 Other common opportunistic infections include candidial oral thrush and diaper area dermatitis. The progression of disease and its manifestations have to be monitored closely in HIV infected children. However no absolute guide lines exits for the frequency of monitoring the laboratory parameters. The approach is usually individualized depending on the clinical condition, HIV classification, treatment modalities being used and if patient is participating in research protocols.