Hiv/aids: Complications and Challenges; the Nigerian Experience in Pediatric Practice

INTRODUCTION Human Immunodeficiency Virus (HIV) is a retrovirus and belongs to the lentivirus family . The HIV was first identified in 1983 and was shown to be the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1984. HIV infection is characterized by the depletion of the CD4 + helper/ inducer subset of T-lymphocytes, leading to severe immune deficiency, constitutional symptoms, neurological diseases, and opportunistic infections and neoplasm (reviewed in Fauci and Lane). Two genetically different but related forms of HIV, called HIV-1 and HIV-2, have been isolated from patients with AIDS. HIV-1 is found worldwide and is responsible for the worldwide pandemic, and HIV-2, found mainly in West Africa, Mozambique, and Angola. HIV-2 is less pathogenic and makes little or no contribution to paediatric AIDS; therefore, all discussion in this seminar refers to HIV-1. HIV-1 has been divided into other sub types based on the genetic analysis constituent of M (Major) and O (Outliers); hence there are subgroups or sub-types A, B, C, D, E. The following subtypes are seen in Africa: A and D (East and Central), C (Southern Africa in over 90% of cases), and A recombinants (West Africa). Subtype C appears to be more virulent than all the other subtypes. Epidemiology of HIV Infection/ Burden of the Disease