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Issue No. 12 | May 22, 2018

News and Features

HHS Pediatric Antiretroviral Treatment Guidelines Updated

The HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV (the Panel) has released an updated version of the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.

Some of the key guideline updates include:
  • In the Introduction, the Panel describes the process of coordinating with the authors of the Perinatal Guidelines to jointly develop the three sections of the Pediatric Antiretroviral (ARV) Treatment Guidelines that are shared with the Perinatal Guidelines.
  • The Panel now recommends performing viral load measurements every 3 to 4 months to monitor antiretroviral therapy (ART) adherence and disease progression. The list of bulleted recommendations in Clinical and Laboratory Monitoring of Pediatric HIV Infection has been updated to reflect this change.
  • The recommendations in When to Initiate Therapy in Antiretroviral-Naive Children have been revised. The Panel now recommends that all children receive ART, regardless of symptoms or CD4 T lymphocyte count.
  • An additional column and footnotes indicating which drugs are available in fixed-dose combination (FDC) formulations were added to Table 7 in What to Start: Regimens Recommended for Initial Therapy of Antiretroviral-Naive Children.
  • Didanosine and stavudine are no longer recommended for use in ARV regimens, due to the significant toxicities of these drugs and the availability of safer agents. Table 9 and Table 10 in What Not to Start: Regimens Not Recommended for Initial Therapy of Antiretroviral-Naive Children have been updated accordingly.
  • Considerations About Interruptions in Antiretroviral Therapy now includes issues that may contribute to interrupted treatment in children from limited resource settings and emphasizes the need to plan for potential interruptions.
  • A number of the drug sections in Appendix A: Pediatric Antiretroviral Drug Information now include new pediatric data and dosing and safety information, as well as new drug formulations and FDCs.

For a complete list of guideline updates, please see What's New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the PDF version of the guidelines.

To view or download the guidelines, go to the Pediatric ARV Guidelines section of AIDSinfo. Separate PDF files that contain only the guideline tables or the boxed recommendations can also be downloaded from the page.

Send Comments on the Revised Guidelines to AIDSinfo

Feedback on the revised Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection is welcome. Please email your comments with the subject line “Comments on the Pediatric ARV Guidelines” to by June 5, 2018.