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It has been reported worldwide that health problems caused by environmental pollution disproportionately affect unborn babies and small children. It is also known that children go through some developmental phases that are highly sensitive to certain pollutants. When unborn and small children go through physical and mental development, different organs develop at different times, and as such, some organs are more sensitive than others to certain materials during certain developmental phases. In addition, some researchers support the so-called Barker hypothesis, which suggests that low nutritional conditions before birth result in lifestyle-related diseases later as adults | Current HIV Research 2007 5 139-153 139 Disease Progression in Children with Vertically-Acquired HIV Infection in Sub-Saharan Africa Reviewing the Need for HIV Treatment Kirsty Little1 Claire Thorne1 Chewe Luo2 Madeleine Bunders1 Ngashi Ngongo2 Peter McDermott3 and Marie-Louise Newell .1 Centre for Paediatric Epidemiology and Biostatistics Institute of Child Health University College London UK 2Health Section UNICEF New York USA 3HIVSection UNICEF New York USA Abstract Approximately 700 000 children become newly infected with HIV annually mainly through mother-to-child transmission MTCT making paediatric HIV a leading cause of morbidity and mortality worldwide. The substantial interest in preventing MTCT PMTCT has generated information on rates of transmission and associated factors but there is a lack of information on disease progression and mortality in vertically-infected children especially from resource-poor settings. Peer-review journals with titles or abstracts containing reference to the review s themes were selected using widely available search engines. We review relevant literature on mortality in children born to HIV infected mothers morbidity and mortality associated with paediatric HIV infections eligibility to and efficacy of antiretroviral therapy ART . Child mortality is independently associated with maternal HIV status and maternal death with paediatric infection resulting in 4 fold increase in mortality by age 2 years. Morbidities seen in infected children were similar to those seen in uninfected children although the rates and recurrences of illness were greater. There is some evidence that progression to AIDS may be more rapid in resource poor settings although data on this are very limited. PMTCT and paediatric ART have been shown to be highly successful in resource-limited settings but are not universally applied. Further efforts to increase coverage of both PMTCT and paediatric ART could substantially reduce the numbers of children becoming
