Fungal infections in children with human immunodeficiency virus infection

The increasing prevalence of fungal infections is caused in large part by the human immunodeficiency virus (HIV) epidemic. HIV-associated immunodeficiency is a major risk factor for invasive fungal disease. The prevalence of fungal infections in adults with HIV infection is markedly increased, and a large body of information about their incidence, course, and prognosis in adults exists. However, fungal infections, except candidiasis, are less common in children with HIV infection, and information about their pathogenesis is limited. The reason for this difference is unknown. This article reviews the occurrence of systemic fungal infections in children with HIV infection. Despite the relative rarity of infections with the ubiquitous and endemic fungi in the first 2 decades of the HIV epidemic, the increasing number of children with longstanding HIV infection in the era of highly active antiretroviral therapy warrants close surveillance for and aggressive treatment of fungal infections in children with HIV infection.