HIV-positive children display a range of signs and symptoms and these are categorised according to the Centers for Disease Control classification system, shown in the table below.

Common clinical features of HIV infection in children are:

• Hepatosplenomegaly (enlarged spleen or liver).
• Chronic or recurrent diarrhoea.
• Fever and recurrent otitis (inflammation of the ear) or sinusitis (inflammation of the sinuses).
• Recurrent bacterial infections
• Lymphoid Interstitial Pneumonitis (LIP) (inflammation of the lung) may be found in approx 20-30% of vertically infected children, however this is not common in adults. It may be found in children who are asymptomatic or who have chronic hypoxia (low blood oxygen), and it is usually diagnosed by chest X-Ray. Causative factors may include abnormal reaction to Epstein-Barr Virus (EBV).
• Other respiratory diseases such as Mycobacterium Tuberculosis may be difficult to distinguish from LIP on x-ray.
• Other respiratory conditions associated specifically with HIV, such as Pneumocystis Pneumonia and disseminated CMV, usually present in children with severe immunosuppression. In particular, infants below one year of age may present with these symptoms. Septrin prophylaxis is recommended for all HIV-positive infants below one year.
• Malignancies, such as Lymphoma and Kaposi's sarcoma, are rare presentations in children.
• HIV encephalopathy can be a presentation in children with rapid disease progression. It can manifest itself with symptoms which range in severity, from loss of developmental milestones in babies, to difficulties with gait in young infants and children, to loss of concentration and faltering cognitive function in older school age children. Monitoring any deterioration is vital. Developmental assessments will capture any progression. MRI (Magnetic resonance imaging) scans and cranial (brain) imaging are useful monitoring tools.