Paediatric guidelines on the prevention and treatment of OIs (November 2013)
In November 2013, the US DHHS paediatric guidelines for prevention and treatment of HIV related opportunistic infectsions (OIs) were published.
Major changes from the previous version in 2009 include:
- Greater emphasis on the importance of antiretroviral therapy (ART) for prevention and treatment of OIs, especially those OIs for which no specific therapy exists.
- Increased information about diagnosis and management of IRIS.
- Information about managing ART in children with OIs, including potential drug-drug interactions.
- Updated immunisation recommendations for children who have either been exposed to or infected with HIV, including pneumococcal, human papillomavirus, meningococcal, and rotavirus vaccines.
- Addition of sections on influenza, giardiasis, and isosporiasis.
- Elimination of sections on aspergillosis, bartonellosis, and HHV-6 and HHV-7 infections.
- Updated recommendations on discontinuation of OI prophylaxis after immune reconstitution in children.
The most important recommendations are highlighted in boxed major recommendations preceding each section, and a table of dosing recommendations appears at the end of each section.
The guidelines conclude with summary tables that display dosing recommendations for all of the conditions, drug toxicities and drug interactions, and 2 figures describing immunisation recommendations for children aged 0 to 6 years and 7 to 18 years.
Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Department of Health and Human Services.
http://aidsinfo.nih.gov/contentfiles/lvguidelines/ oi_guidelines_pediatrics.pdf (PDF)