Liver tissue from autopsies of 29 cases of children with acquired immunode¢ciency syndrome (AIDS) were collected from three major South America (SA) pediatric hospitals.The hepatopathologic ¢ndings were classi¢ed in the samefashion as in a series of 61children with AIDSfrom North America (NA): in£ammation, nonspeci¢c, lymphoproliferative disorders, and giant cell transformation. By comparing both groups, we noted that the SA children were younger at time of death which was consistent with a more rapid progression of the disease. Opportunistic infections varied with a higher prevalence of cytomegalovirus (CMV) infection in SA children.The histopathologic features of CMV in the livers of SA children were associated with a conspicuous in£ammation absent in the NA group. F|nally, di¡erent nonspeci¢c hepatic changes were found in SA children, including one case of peliosis hepatis.