What's New in the Guidelines for Use of Antiretroviral Agents in Pediatric HIV Infection?

26 Apr 2023 • These comprehensive guidelines detail the care of children with HIV exposure and infection, including recommendations for HIV testing during pregnancy and early infancy, and during antiretroviral treatment(ART). Key Recommendations and Updates:

  • Infants born to individuals with sustained viral suppression (2 tests 4 weeks apart with <50 copies/mL) should receive just 2 weeks of zidovudine prophylaxis rather than the 4–6 recommended for all other exposed infants.
  • Individuals with sustained undetectable viral loads can be supported in their decision to breast-feed their infants. For those infants who are breast-fed, virologic testing is recommended at 1–2 months and 4–6 months in addition to the standard recommended testing at 14–21 days, 1–2 months, and 4–6 months.
  • ART should be initiated immediately following HIV diagnosis except in the presence of a concomitantly diagnosed opportunistic infection due to concerns about immune reconstitution (i.e., cryptococcal meningitis and mycobacterial disease).
  • Choices of antiretroviral regimens as well as nonrecommended drugs and drug combinations (e.g., monotherapy, dual nonnucleoside reverse transcriptase inhibitor therapy) are listed in addition to guidance regarding specific agents for adolescents to increase medication adherence.
  • Management of medication toxicity, clinical and laboratory monitoring, and CD4 counts and percentages in healthy children are detailed.

Source: HIV Gov | Click to read the guidelines

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