Objective: (1) To determine the most common AI's in HIV infected and exposed children and to compare their frequency in this population. (2) To evaluate the effect of changing antiretroviral therapy and of IVIG infusion on decreasing the rate of these AI's.

Methods: The records of 130 children of whom 53 were infected(cases) and 77 uninfected (controls) were reviewed. Data were collected on all AI's with regards to etiology, temporal relationship to IVIG infusion and antiretroviral therapy.

Results: URI was the most common AI, affecting 47 (88%) cases(average 2.6 episodes/patient) and 50 (64%) controls (average 1.8 episode/patient). Otitis media was the second common AI, affecting 68% of cases (average 3 episodes/patient) and 51% of controls (average 1.5 episode/patient). Pneumonia documented radiologically was the third most common AI, affecting 50% of cases (average 2 episodes/patient) vs. 10% of controls (1 episode/patient). The other common AI's in order of decreasing frequency included oral candidiasis, skin infection, sinusitis and gastroenteritis. All were also more frequent in cases compared to controls. Changing antiretroviral therapy improved the CD4 cell-count in 37 (80%) of infected patients and decreased the frequency of AI's in 33 (70%) of patients. Of these 33 patients, 8 (25%) had no improvement of their CD4 cell-count. The introduction of IVIG decreased the rate of AI's other than mucocutaneous infections by 47%, although it did decrease the severity of the mucocutaneous involvement.

Conclusion: Changing antiretroviral therapy and initiating IVIG infusion appear to be beneficial in reducing AI's even when CD4 cell-count does not show improvement.