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Issue No. 33 | August 11, 2011

News and Features

Updated HHS Pediatric Antiretroviral Treatment Guidelines Now Available in PDF and HTML Formats

AIDSinfo announces the release of the updated Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Key updates and new information included in the guidelines are prefaced in What’s New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the text and tables of the guidelines.

In addition to the customary printer-friendly PDF format, the pediatric guidelines are now also available in a Web-based format. The Web-friendly HTML format makes it easy to navigate through the pediatric guidelines and to quickly search for information. The updated guidelines also include a QR code on the cover of the document. Scan the code using your Smartphone to view the guidelines on the AIDSinfo mobile site.

Selected key updates to the guidelines include:

  • Revised recommendations in When to Initiate Therapy including an update increasing the CD4 threshold for recommending antiretroviral therapy (ART) in children with minimal or no clinical symptoms who are 5 years or older (from CD4 count <350 cells per mm3 to <500 cells per mm3).
  • Updates in What Drugs to Start including a general discussion of factors to consider when selecting an initial antiretroviral (ARV) regimen for children and a specific discussion regarding choice of non-nucleoside reverse transcriptase inhibitor (NNRTI)- versus protease inhibitor (PI)-based regimen, including citations providing recent results from pediatric clinical trials. Updated guidance on preferred regimens for initial therapy in children include a recommendation for lopinavir/ritonavir-based therapy as the preferred initial therapy regimen for children younger than 3 years and the addition of atazanavir/ritonavir as a preferred nucleoside reverse transcriptase inhibitor (NRTI) for children age 6 years or older.
  • Addition of new sections on central nervous system (CNS) toxicity, gastrointestinal (GI) effects, nephrotoxicity, and peripheral nervous system toxicity to the tables on Antiretroviral Therapy-Associated Adverse Effects and Management Recommendations.
  • Addition of new section on management of children with ongoing adherence problems as the reason for viral failure in Antiretroviral Treatment Failure and discussion of the option for use of lamivudine or emtricitabine alone as an interim “bridging regimen” in the special circumstance of children with treatment failure associated with drug resistance and persistent nonadherence.
  • Reorganization of the Pediatric Antiretroviral Drug Information appendix to improve readability and addition of updated data for specific drugs.

For a complete preview of key updates to the guidelines, see What’s New in the Guidelines.

To view or download the guidelines, go to the Pediatric Guidelines section of AIDSinfo. (Separate PDF files of the tables can also be downloaded from the page.) Or go to the AIDSinfo Order Publications page to request the guidelines via e-mail.

Your Feedback Is Welcome

The HHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children invites feedback on the latest revisions to the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Please send your comments with the subject line "Comments on Pediatric Guidelines" to by August 30, 2011.