Background. - Assessment of economic implications of pediatric HIV inf
ection allows to document efforts which are devoted by health care sys
tem to the care of children born to HIV infected women. This paper pre
sents the results of the first analysis, in the French health care con
text, of direct medical costs related to HIV mother-to-child risk of t
ransmission. Material and methods. - Statistical prospective analysis
was performed on 853 files concerning 152 children followed in three m
edical centers. Because the medical consumptions data were linked to c
linical status, average direct medical costs per medical contact could
be defined for each center. Results. - Results were consistent with t
he hypothesis that more medical care is necessary when the clinical pi
cture is uncertain (indeterminate status) or reflects health state det
erioration. However, results are very different according to HIV clini
cal status and disparities may be so large that costs per clinical sta
tus hierarchy may be disrupted. Explicative factors for these variabil
ities are expressed in terms of patient recruitement, medical uncertai
nty management and resources disponibility.