Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children
The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.
Last Updated: July 26, 2018; Last Reviewed: July 26, 2018
Strength of Recommendation: Strong; Weak
Quality of Evidence: High; Moderate; Low; or Very Low
a As of the 2017–2018 influenza season, live attenuated influenza vaccine (LAIV) is not recommended by ACIP for any pediatric or adult patient given concerns about effectiveness. Please see the most recent ACIP statements regarding use of LAIV in future seasons.
|Indication||First Choice||Alternative||Comments/Special Issues|
(Pre- and Post-Exposure)
Influenza A and B
Indications Recommended For:
Note: Duration of chemoprophylaxis depends on the type of exposure, whether influenza vaccination was provided after the exposure, and whether influenza vaccine is anticipated to be effective based on the child’s degree of immunosuppression and the degree of match with circulating influenza viruses.
||N/A||N/A||No role for secondary chemoprophylaxis|
Influenza A and B
a Oseltamivir is FDA-approved for prophylaxis of influenza in children aged ≥1 year. It is not approved for prophylaxis in children aged <1 year. However, CDC recommends that health care providers who treat children aged ≥3 months to <1 year administer a chemoprophylaxis dose of oseltamivir 3 mg/kg body weight/dose once daily. Chemoprophylaxis for infants aged <3 months is not recommended unless the exposure situation is judged to be critical.
b Zanamivir is not recommended for chemoprophylaxis in children aged <5 years or for children with underlying respiratory disease.
c See Fiore 2011 and Influenza Antiviral Medications: Summary for Clinicians for further details.
d See Acosta et al. J Infect Dis 2010; 202:563-566 for dosing recommendations in premature infants.
e Oseltamivir is FDA-approved for treatment of influenza in children aged ≥2 weeks; however, both CDC and AAP recommend use of oral oseltamivir for influenza treatment in infants aged <2 weeks.
f Zanamivir is not recommended for treatment in children aged <7 years or for children with underlying respiratory disease.
Key to Acronyms: AAP = American Academy of Pediatrics; CDC = Centers for Disease Control and Prevention; CrCl = creatinine clearance; ESRD = end stage renal disease; FDA = Food and Drug Administration; PK = pharmacokinetic