n Southern African Journal of HIV Medicine - Guidelines for antiretroviral therapy in children : ART in children

Volume 1, Issue 2
  • ISSN : 1608-9693
  • E-ISSN: 2078-6751



As a result of the present high cost antiretroviral therapy (ART) will be denied to the majority of HIV-infected children in sub-Saharan Africa. Access to ART is now a clear discriminator between the 'haves' and 'have nots'. While this situation is unacceptable, ART is becoming an increasing option in paediatric practice. Promoting affordable ART for children is a priority for clinicians, health administrators and the pharmaceutical industry. The use of ART in children is a highly specialised field. Initial and ongoing management of HIV-infected children by a paediatrician experienced in this field is strongly recommended. If this is impossible, we recommend consultation with such a paediatrician before initiation of ART so that the child may benefit from the most optimal regimen. Certainly, when a clinician decides to change therapy, consultation with an experienced treater should occur in order to ensure maximum efficacy of the new regimen. ART in children follows the same principles as in adults, but generally lags behind in terms of its application in paediatric HIV medicine. The reasons for this are complex and include a reluctance to use new medication in children before efficacy and safety have been confirmed in adults, the need to develop liquid formulations, and because dosage adjustments are necessary. As a result, there are fewer therapeutic options available for children.

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