U.S. Issues New Guidelines for Treating Children With HIV
Experts at the U.S. National Institutes of Health and the Centers for Disease Control and Prevention have revised their guidelines on the prevention and treatment of dangerous infections in children with HIV.
The new guidelines -- which update 2004 recommendations -- stress the importance of using powerful antiretroviral drugs to suppress the virus that causes AIDS, and offer guidance on when medicines might be discontinued once a child's immune system recovers.
"The guidelines will help health-care workers and public health officials who work with children to save lives that might otherwise be lost," Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said in a joint NIH/CDC news release. "The infections that can accompany HIV are often the major cause of illness and death of HIV-infected children."
Children with HIV have depleted immune systems and are therefore vulnerable to so-called "opportunistic" infections, including tuberculosis and pneumonia. These types of infections remain the leading cause of death for HIV-infected children, the news release stated.
The new guidelines, to be published in the Sept. 4 issue of the CDC's Morbidity and Mortality Report, include:
* a renewed emphasis on the use of antiretroviral drugs to keep HIV at bay,
* advice on managing "immune reconstitution inflammatory syndrome," a potentially dangerous over-activity of the immune system which can occur as formerly impaired immune responses rebound under treatment,
* information on drug interactions for children on HIV medications,
* new advice on the use of antibiotics to fight off a form of pneumonia that often threatens newborns suspected of being HIV-positive,
* updated advice on immunizing HIV-positive children against pathogens such as hepatitis and HPV,
* new recommendations that might allow some well-treated, HIV-infected children with newly robust immune systems to discontinue medicines aimed at preventing opportunistic infections. Formerly, experts advised that people stay on these medicines for life.
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