Guideline Detail

Guidelines for the Management of HIV in Children

Source: South Africa National Department of Health
Publication Date: January 1, 2010

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2010 South Africa National Department of Health recommendations for caring for children with HIV infection. Topics addressed include antiretroviral therapy (ART) in South Africa; principles of HIV management in children; HIV infection and the human immune system; modes of transmission; disease progression; prevention of paediatric HIV infection; clinical features of HIV infection in children; clinical staging HIV infection; HIV testing in children; prevention of mother-to-child transmission follow-up; confirmation of HIV status and initiation of ART; routine follow-up visits; cotrimoxazole prophylaxis; additional preventive care for HIV-infected children; counselling and support; nutrition interventions; nutritional support; guidelines for feeding children with asymptomatic HIV infection; guidelines for feeding children with symptomatic HIV infection; feeding problems; food supplementation; management of severely malnourished children with HIV; principles for ART; delivery of ART; goals of ART; eligibility for ART; initiating ART in children; routine monitoring; second-line regimens; salvage treatment; single drug substitution of stavudine with abacavir; administration of antiretrovirals; concomitant tuberculosis (TB); grading of adverse events; response to adverse events; lactic acidosis; nevirapine hepatotoxicity; abacavir hypersensitivity reaction; lipodystrophy syndrome; important drug interactions; immune reconstitution inflammatory syndrome; Bacillus Calmette-Guérin adverse events; anaemia in HIV-infected children; respiratory complications, including bacterial pneumonia, Pneumocystis jiroveci pneumonia, TB, and lymphoid interstitial pneumonia; gastrointestinal conditions, including acute gastroenteritis, dysentery, persistent diarrhoea, and candidiasis; common skin conditions in HIV-infected children, including herpes simplex virus, chickenpox (varicella), herpes zoster, seborrhoeic dermatitis, molluscum contagiosum, warts, impetigo, tinea (ringworm), dry skin and itching, and drug-related skin reactions; other complications and opportunistic infections, including cryptococcal meningitis, cytomegalovirus infection, disseminated infection with mycobacterium avium complex, toxoplasmosis, HIV encephalopathy, wasting syndrome, and malignancies; managing pain in HIV-infected children; supportive care of terminally ill children; home care for terminally ill children; considerations for ART in adolescents; postexposure prophylaxis (PEP) and safe working practices, including universal precautions, procedure for sharps injury or other exposure, and PEP following alleged penetrative sexual abuse; psychosocial support; legal issues, including HIV testing of children; pre- and posttest counselling; confidentiality in counselling; adherence issues, including the role of the healthcare team, strategies to promote adherence, and basic adherence package at initiation; reasons for disclosing HIV status to children; and guidelines for the disclosure of HIV status to children.

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Keywords: HIV - Resource-Limited Settings, HIV - Paediatric/Adolescent Patients, HIV - Basic Science and Mechanisms of Action, HIV - Prevention, HIV - Diagnosis, HIV - First-line Therapy, HIV - Switch Strategies, HIV - Treatment-Experienced Patients, HIV - Tuberculosis, HIV - Adverse Events, HIV - IRIS, HIV - Dyslipidaemia, HIV - Drug-Drug Interactions, HIV - Dermatologic Complications, HIV - Herpes Simplex Virus, HIV - Pneumocystis jiroveci pneumonia (PCP), HIV - Varicella Zoster Virus, HIV - Mycobacterium avium Complex, HIV - Malignancies, HIV - Wasting, HIV - Adherence