n CME : Your SA Journal of CPD - Paediatric antiretroviral therapy for the general practitioner : main article
|Article Title||Paediatric antiretroviral therapy for the general practitioner : main article|
|© Publisher:||Health and Medical Publishing Group (HMPG)|
|Journal||CME : Your SA Journal of CPD|
|Author||Heather B. Jaspan, James J.C. Nuttall and Brian S. Eley|
|Publication Date||May 2005|
|Pages||222 - 228|
|Keyword(s)||Antiretroviral therapy, Children, Clinical staging, Drug regimens, General practitioners, Highly active antiretroviral therapy, HIV infection, Immunological staging, Monitoring, Treatment failure and Tuberculosis treatment|
The natural history of perinatal HIV infection is somewhat different to that of adults. Children have much higher viral loads. <br>Children's clinical staging follows a modified WHO 3 staging system. Their immunological monitoring is according to CD4 percentage rather than absolute count until about 6 years of age. <br>Children often cannot swallow pills, syrups can be unpalatable and some require refrigeration. <br>Many drugs have not undergone safety testing in young children, therefore options for therapy are limited. <br>Due to high viral loads to start with, children are harder to treat and we sometimes tolerate detectable levels of vireamia if clinical and immunological improvement is sustained. <br>Drug metabolism changes quite rapidly in the first years of life, therefore drug dosing requires careful calculations. <br>Drug dosing goes according to body weight and surface area, and therefore necessitates dose adjustments at almost every visit.
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