The HIV infection epidemic is still horrifyingly widespread. There were 4.5 million fatalities from HIV in 2001, with an estimated 1.4 million children afflicted. In the UK, paediatric cases are concentrated in places with high populations of infected adult immigrants and, to a lesser extent, in regions with high IV drug misuse rates. The southeast and London continue to have the highest incidence. Any clinician in any field might anticipate working with children who are HIV positive or have clinical AIDS as a result of the countrywide redistribution of immigrant and refugee families. The majority of children are vertically infected, meaning they are infected before, during, or after birth by their infected mother. Rates of transmission range from 15% to 20% in developed countries. ENT doctors may treat children with HIV infection as their initial presentation, and they should have the proper suspicion levels for the diagnosis. The most frequent presenting symptoms are fever, hepatosplenomegaly, chronic or recurring diarrhoea, persistent generalised lymphadenopathy, and poor development. By the age of 12 months, 15–20% of untreated infants will have an AIDS-defining disease, often Pneumocystis pneumonia around 3–4 months of age. Without treatment, 70% of perinatally infected infants will show some indications or symptoms by the time they are 12 months old; the median age at which AIDS progresses is 6 years; and, by this time, 25–30% will have passed away. The average death age is nine years.