n Southern African Journal of HIV Medicine - When to start antiretroviral therapy in HIV-infected children : commencing paediatric ART
|Article Title||When to start antiretroviral therapy in HIV-infected children : commencing paediatric ART|
|Journal||Southern African Journal of HIV Medicine|
|Publication Date||Jan 2002|
|Pages||9 - 11|
|Keyword(s)||Chris Hani Baragwanath Hospital|
The right time to start antiretroviral therapy (ART) in adults and children is currently a topic of much discussion. Delaying the initiation of ART in children until absolutely necessary is of compelling importance for several reasons. Experience in the USA and Europe shows that achieving adequate long-term adherence in children remains a major challenge. Poor adherence is responsible for the emergence of resistant strains of HIV, resulting in treatment failures. Prolonged ART in children also exposes them to the increased risk of toxic side-effects. Metabolic complications (lactic acidosis, lipodystrophy) of ART have been well documented in adults and are now being described in children. Importantly, in settings where resources are limited, delayed initiation of treatment could be a mechanism for reducing the cost of management.
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