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.

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What's New

Last Updated: October 25, 2019; Last Reviewed: October 25, 2019

After the 2013 full guidelines release, the Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children (the Panel) modified its process so that individual sections would be published as they were updated, allowing for more timely appearance of new recommendations. Each section will be marked with the date of its last update and the summary of changes will be listed below. For a full description of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children, see the updated Summary.

Additionally, the evidence review and recommendation rating system underwent major changes; this new approach is incorporated into sections as they are individually updated. As a result, topics not yet updated since the 2013 release reflect the former rating system, and sections updated since 2013 use a newer, modified GRADE system. A description of the methods of collecting and synthesizing evidence and formulating and rating recommendations appears in the Background and Recommendations Rating Scheme section. 

Major section revisions within the last 6 months are as follows:

October 25, 2019

  1. Vaccine-Preventable Diseases in Children and Adolescents with HIV Infection: The Panel updated this section and the recommended immunization schedule to include new vaccines available for the prevention of meningococcal infection (MenACWY-D [Menactra], MenACWY-CRM [Menveo], MenB-4C [Bexsero], and MenB-FHbp [Trumenba]) and HPV (9vHPV), and to include an expanded discussion of yellow fever vaccine (YFV) recommendations for children with HIV. The section has also been updated to reflect the new recommendation rating system and references were added.

    The recommended immunizations schedule has been consolidated from two figures (ages 0-6 and 7-18 years) into a single schedule (Figure 1) spanning birth through age 18 years. Updates reflect 2019 Advisory Committee on Immunization Practices (ACIP) recommendations, which include specific recommendations for children with HIV.

August 29, 2019

  1. Cryptosporidiosis: There are no major changes to the guidance for the diagnosis and management of cryptosporidiosis in children and adolescents living with HIV. Minor updates to the main text of the section include additional information on epidemiology, clinical manifestations, and new diagnostic methodologies, along with updated references and links to additional resources on preventive measures. The section has been updated to reflect the new recommendation rating system.

August 22, 2019

  1. Giardiasis: There are no major changes to the guidance for the diagnosis and management of giardiasis in children and adolescents living with HIV. Minor updates to the main text of the section include information on new diagnostic methodologies and additional details on the approach to diagnosis when giardiasis is suspected but stool testing is negative. The section has been updated to reflect the new recommendation rating system and references were added.

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