oa Editorial [Hot Topic: The Evolving Challenges in Pediatric HIV Management (Guest Editors: Emanuele Pontali and Raffaella Rosso)]

About 30 years ago the first cases of AIDS among adults were reported in MMWR [1]. It was soon clear that the HIV epidemic was affecting not only adults but also children [2]. The search for a treatment started almost immediately and the first drug identified for antiretroviral treatment (ART) was zidovudine for both adults and children [3, 4]. In less than ten years the time of Highly Active Antiretroviral Treatment (HAART) came for adults [5]. It took some more time to have a triple combination of antiretroviral drugs as the standard of care in children, too [6]. Excellent results arrived soon, but it rapidly became clear that ART management presented several challenges [7, 8]. Nowadays, we are facing a pediatric HIV epidemic that has virtually stopped expanding in developed countries. Conversely, in developing countries there is still an ongoing epidemic, although progressing slower than in the past [9]. In particular, the majority of new pediatric cases of HIV infection are concentrated in this latter area of the world. When planning for this special issue it was considered interesting to collect updated information that could support pediatricians working where most cases of HIV infection in children are (i.e. first- and second-line ART in resource-limited settings; TB/HIV co-infection). Nevertheless, issues not strictly related to developing countries, but also challenges for pediatric ART that could be relevant for all settings (i.e. adherence; pharmacokinetics; immune recovery) were addressed. This special issue could not necessarily cover all possible issues of pediatric HIV-infection management in all possible settings. However, it can surely provide a source of highly qualified information for those who want to improve management of HIV-infected children in their Institutions.