Acquired immune deficiencies (AIDs) are far more common than the Primary immune deficiencies (PIDs) and should be evaluated/looked for first, prior to evaluating for PIDs. The commonest acquired immunodeficiency is due to human immunodeficiency virus (HIV) infection.
Children with HIV infection present with various clinical manifestation like failure to thrive, recurrent pneumonia, diarrhea, recalcitrant, oral thrush and meningitis. They may not be differentiated clinically from primary immunodeficiencies.
However simple laboratory tests like HIV ELISA in children more than 18 months and positive PCR (HIV-PCR) are confirmatory.
Newer PIDs are being diagnosed each year and some of the deficiencies like severe combined immunodeficiency (SCID) needs urgent diagnosis and intervention like supportive care antibiotics and bone marrow transplantation.
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