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Unresolved Antiretroviral Treatment Management Issues in HIV-Infected Children.
MedLine Citation:
PMID:  22138766     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT: Antiretroviral therapy in children has expanded dramatically in low- and middle-income countries. The World Health Organization revised its paediatric HIV guidelines to recommend initiation of antiretroviral therapy in all HIV-infected children younger than two years, regardless of CD4 count or clinical stage. The number of children starting life-long antiretroviral therapy should therefore expand dramatically over time. The early initiation of antiretroviral therapy has indisputable benefits for children, but there is a paucity of definitive information on the potential adverse effects. In this review, a comprehensive literature search was conducted to provide an overview of our knowledge about the complications of treating paediatric HIV.Antiretroviral therapy in children, as in adults, is associated with enhanced survival, reduction in opportunistic infections, improved growth and neurocognitive function, and better quality of life. Despite antiretroviral therapy, HIV-infected children may continue to lag behind their uninfected peers in growth and development. In addition, epidemic concurrent conditions, such as tuberculosis, malaria and malnutrition, can combine with HIV to yield more rapid disease progression and poor treatment outcomes.Additional studies are required to evaluate the long-term effects of antiretroviral therapy in HIV-infected infants, children and adolescents, particularly in resource-limited countries where concomitant infections and conditions may enhance the risk of adverse effects. There is an urgent need to evaluate drug-drug interactions in children to determine optimal treatment regimens for both HIV and coinfections.
Authors:
Shirin Heidari; Lynne M Mofenson; Charlotte V Hobbs; Mark F Cotton; Richard Marlink; Elly Katabira
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-1
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  -     ISSN:  1944-7884     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aInternational AIDS Society, Geneva, Switzerland bEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA cLaboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Disease (NIAID), NIH, Rockville, Maryland, USA dDepartment of Paediatrics and Child Health, Stellenbosch University and Tygerberg Children's Hospital, South Africa eHarvard School of Public Health, Boston, MA, USA fElizabeth Glaser Pediatric AIDS Foundation, Los Angeles, CA, USA gMakerere University College of Health Sciences, Kampala, Uganda.
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