HIV Management Guide for Clinical Care and ARV Guidelines

HIV Management Guide for Clinical Care and ARV Guidelines

Pediatric Guidelines

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Welcome to the Australian Commentary on the US Department of Health and Human Services (DHHS) Guidelines for the use of Antiretroviral Agents Pediatric HIV infection

What’s New

The HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV (the Panel) has reviewed and updated the text and references of previous versions of the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection published on April 11, 2022, and October 11, 2022. The Australian HIV Paediatrics Guidelines Committee reviewed these updates …

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Introduction

The Australian Commentary to the DHHS Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection has been prepared by the ASHM HIV Paediatric Guidelines Committee along with external contributors (see: Contributors). The US DHHS has agreed to this adoption and adaptation process. The ASHM HIV Paediatric Guidelines Committee provides the commentary and reviews …

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Maternal HIV Testing and Identification of Perinatal HIV Exposure

AU comment: Maternal HIV testing Expedite testing of mother as soon as practicable and if test is positive, a) intrapartum antiretroviral (ARV) prophylaxis should be initiated immediately if mother is still in labour and b) infants should receive an ARV regimen that is appropriate for infants who are at higher risk of perinatal HIV transmission as soon as practicable, pending results …

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Diagnosis of HIV in Infants and Children

AU Comment: Infant virologic diagnostic testing Australian clinicians may prefer to follow the BHIVA guidelines, which recommend virologic diagnostic testing within the first 48 hours (and prior to hospital discharge), at 2 weeks after cessation of antiretroviral prophylaxis, and at 8 weeks after cessation of antiretroviral prophylaxis. In the setting of breastfeeding, infants are recommended to …

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Clinical and Laboratory Monitoring of Pediatric HIV Infection

AU Comment: Monitoring children on ART Height and weight should also be monitored routinely, with drug doses adjusted according to changes in weight. Weight and BMI monitoring are particularly important in children commencing on or changing to ART regimens containing integrase inhibitors (especially bictegravir and dolutegravir) and/or tenofovir alafenamide Reference: Sax et al 2020. AU Comment: Phenotypic resistance testing Phenotypic …

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What to Start

This section has information on What to Start. Please click on the below links or follow the table of contents to access the information you are looking for. Regimens Recommended for Initial Therapy of Antiretroviral-Naive Children Regimens Not Recommended for Initial Therapy of Antiretroviral-Naive Children

Regimens Recommended for Initial Therapy of ARV-Naive Children

AU Comment: Formulations available in Australia Limited formulations approved by the Therapeutic Goods Administration (TGA) and available via the Pharmaceutical Benefits Schedule (PBS), restrict available options for infants and children in Australia. AU Comment: Recommendations for first line ARV regimens in children and adolescents Recommendations for first line antiretroviral (ARV) regimens in children and adolescents …

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When to Initiate Therapy in ARV-Naive Children

AU Comment: Parent/caregiver refusal to commence ART Parental of caregiver refusal to commence ART require a multidisciplinary assessment to evaluate and overcome barriers to commencing ART. Paediatric HIV health care providers should seek guidance from their respective Child Protection Unit in addressing ongoing concerns regarding ART refusal. Panel’s Recommendations Antiretroviral therapy (ART) should be initiated …

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