Book Review

HIV Infection in Children: A guide to practical management

N Engl J Med 1996; 334:476February 15, 1996

Article

HIV Infection in Children: A guide to practical management
Edited by Jacqueline Y.Q. Mok and Marie-Louise Newell. 313 pp. New York, Cambridge University Press, 1995. $59.95. ISBN: 0-521-45421-2

As human immunodeficiency virus (HIV) infection in children becomes a more chronic disease, with an increased mean life expectancy, and as the total number of children with HIV infection and AIDS increases, a textbook such as this one makes a valuable addition to the current literature. This guide to practical management should interest pediatricians and family practitioners, since they are the primary health care providers for these infants and children with complex medical and social problems.

This textbook addresses a broad audience for whom more comprehensive books on HIV-infected children may not be necessary. For such a concise work as HIV Infection in Children, the range of topics and organization are impressive. The epidemiology of HIV, viral replication, immunology, maternal factors, symptom complexes, treatment plans, and psychosocial issues are covered broadly. Primary health care providers, nurses, social workers, or teachers could easily use this book to familiarize themselves with HIV infection in infants, children, and adolescents and initiate appropriate interventions. In addition, the editors set forth the viewpoints of many organizations, including the Centers for Disease Control and Prevention (CDC), the World Health Organization, and the European Collaborative Group, a feature that will appeal to health care providers worldwide.

Just as important as the medical issues are the psychosocial issues related to HIV infection in children. The editors have shown a sensitivity to these issues by including information relevant to nursing, care of the dying child, and care of the child with one or both parents who have died or are dying, as well as the perspective of a schoolteacher trying to integrate the HIV-infected child into the classroom.

A textbook on HIV infection may become out of date very quickly. Examples of new developments include the new CDC classification system for pediatric HIV infection and the use of zidovudine to decrease the risk of perinatal transmission of HIV. Addenda to several chapters provide new data, but I found the addenda confusing at times, since references to the text are often insufficient and not in context.

To make the text concise, the editors have abbreviated sections of the book. One part that is perhaps condensed more than it should be is the discussion of associated medical symptoms in the HIV-infected child. Other sections that are considerably abbreviated include the discussions of cardiovascular abnormalities and renal problems. The topic of HIV infection in adolescents might have been included. The chapter on hemophilia partially addresses this topic, but there is a separate population of adolescents, those with HIV infection unrelated to transfusion, who have different problems.

Mok and Newell should be applauded for assembling a comprehensive, well-organized, and readable yet concise textbook that will appeal to a broad group of practitioners caring for HIV-infected children.

Tracie L. Miller, M.D.
Children's Hospital, Boston, MA 02115