Guidelines

The Australian Commentary has been written and reviewed by members of the ASHM HIV Paediatric Guidelines Committee. The members of the Committee and other contributors who contributed to the Australian Commentary from 2020-2023 are listed below: Name Position Adam Bartlett (chair) Research Fellow, The Kirby Institute Paediatric Infectious Diseases Physician, Sydney Children’s Hospital Brett Richie …

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Panel’s Recommendations Outside the context of clinical trials, structured interruptions of antiretroviral therapy are not recommended for children (AII). Rating of Recommendations: A = Strong; B = Moderate; C = Optional Rating of Evidence: I = One or more randomized trials in children† with clinical outcomes and/or validated endpoints; I* = One or more randomized …

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AU Comment: Raltegravir granules Raltegravir granules are NOT currently available in Australia. AU Comment: Age and weight based criteria Age and weight based criteria may differ in Australia. AU Comment: Maraviroc Maraviroc is NOT licensed for children in Australia. AU Comment: ibalizumab ibalizumab is NOT currently licensed for children in Australia. AU Comment: Travel with ART A supportive letter may be required to …

Management of Children Receiving ART Read More »

Panel’s Recommendations In children with HIV who have severe or life-threatening toxicity (e.g., a hypersensitivity reaction), all antiretroviral (ARV) drugs should be stopped immediately (AIII). Once symptoms of toxicity have resolved, ARV therapy should be resumed with substitution of a different ARV drug or drugs for the offending agent(s) (AII*). When modifying ARV therapy because of toxicity or …

Management of Medication Toxicity or Intolerance Read More »

Panel’s Recommendations Strategies to maximize adherence should be discussed before and/or at initiation of antiretroviral therapy (ART) and before changing regimens (AIII). Adherence to therapy must be assessed and promoted at each visit, and strategies to maintain and/or improve adherence must be continually explored (AIII). In addition to viral load monitoring, at least one other method of …

Adherence to ART in Children and Adolescents with HIV Read More »

AU Comment: Adolescents living with HIV ASHM provides some guidance for clinicians in Australasia managing adolescents living with HIV and their transition to adult services, refer to HIV Management Guidelines, chapter: HIV infection in adolescents transitioning to adult care. Panel’s Recommendations All adolescents with HIV should receive maximally suppressive antiretroviral (ARV) therapy; this is urgent for …

Special Considerations for ART Use in Adolescents with HIV Read More »

AU Comment: Australian national guidance Although some Australian states and territories have individual perinatal guidelines, Australian National guidance is primarily available via the ASID Management of Perinatal Infections guidelines, which are in turn based on the BHIVA guidelines for the management of HIV in pregnancy and postpartum. The Australian Commentary on the DHHS guidelines will include references to both …

ARV Management of Newborns with Perinatal HIV Exposure or HIV Infection Read More »

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 …

When to Initiate Therapy in ARV-Naive Children Read More »

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

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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