New research suggests that HIV-positive children in developing countries are six times more likely to die from pneumonia than children without the virus.

Researchers from the University of Edinburgh found that  in one year, pneumonia affected 1.4 million children with HIV and led to a further 88,000 deaths. They believe that child pneumonia deaths could be dramatically reduced with improvements in early testing for HIV in infants, antiretroviral therapy (ART) for pregnant women and young children and vaccination.

"Pneumonia management in HIV infected children requires an integrated approach from national governments and international agencies,"Dr. Harish Nair, who led the study, said in a statement. "Pneumonia and HIV case diagnosis needs to be strengthened at primary care level and antiretroviral therapy scaled up rapidly in pregnant women and young children."

The greatest number of HIV cases occurred in Sub-Saharan countries. In Swaziland, Lesotho and Zimbabwe, up to 20 percent of all pneumonia cases and 60 percent of all pneumonia deaths occurred in HIV-positive children. Globally, there are 3.2 million HIV-positive children under 14 years of age, almost 90 per cent of whom live in sub-Saharan Africa.

For the study, researchers examined HIV and pneumonia cases in under-fives in 133 developing countries in Africa and South East Asia in 2010.

Pneumonia is strongly linked to poverty, poor living conditions, inadequate health services, malnutrition and HIV infection. Africa and South East Asia are the worst affected regions, where pneumonia is a leading cause of death in children.

"Revised guidelines by the World Health Organization for childhood pneumonia management must be fully implemented if substantial falls in pneumonia morbidity and mortality are to be achieved in badly affected countries," Nair said.

The findings are detailed in the journal The Lancet Infectious Diseases.