The clinical characteristics of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in children differ substantially from those in adults, and these differences are important to consider in providing both medical and nutrition care. Growth failure, wasting, and loss of active lean tissue are all associated with increased mortality and accelerated disease progression. The use of highly active antiretroviral therapy (HAART) has improved the prognosis and life span of children infected with HIV (HIV+) and has reduced rates of wasting. However, the emergence of HIV-associated lipodystrophy (HIVLD) has emphasized the extensive nutrition and metabolic manifestations of HIV infection. Maintaining the nutrition status of the HIV+ child is therefore crucial for optimal health outcomes.