Paediatric HIV - Looking beyond CD4 counts

Paediatric HIV remains a significant health and social challenge in sub-Saharan Africa despite many countries gaining improved access to antiretroviral treatment. Paediatric HIV affects multiple body systems and has the potential to cause wide ranging impairments as well as activity and participation limitations. The aim of this paper is to highlight some of the impairments that remain, despite the children having access to better medical care, in order to establish a possible role for physiotherapists. Nine studies conducted through the department of physiotherapy at the University of the Witwatersrand, South Africa are presented. The results of these studies demonstrate the neurodevelopmental, musculoskeletal, respiratory and quality of life challenges which children infected with HIV as well as their caregivers continue to face. The need for long term, multidisciplinary follow up of children infected with HIV is emphasized.