PEDIATRIC HIV

PEDIATRIC HIV

Pediatric HIV

Welcome to the ViiV Healthcare Medical Pediatric HIV site. Pediatric HIV incidence has decreased for infants & children, however remains an issue for youth.1,-3 Getting to zero in Pediatric HIV is essential. This site provides comprehensive educational content and awareness related to the prevention and treatment of Pediatric HIV while facilitating healthcare providers education as we work to end Pediatric HIV.

HIV Information

Care Guidelines

The Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection (Pediatric Guidelines) address the diagnosis of HIV infection in infants and children and the use of antiretroviral therapy (ART) in children and adolescents with HIV. The Pediatric Guidelines also include recommendations for managing adverse events that are associated with the use of antiretroviral (ARV) drugs in children and a detailed review of the safety, efficacy, and pharmacokinetics (PKs) of ARV agents in children.

For adolescents ages 13 and up, the Adult & Adolescent Treatment Guidelines provide guidance on the use of ARVs and their management. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV

Additional information on the management of Opportunistic Infections in children and adolescents are available here: Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children | NIH

https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections

 

Adherence

Adherence to ART is a principal determinant of virologic suppression.4,5 Suboptimal adherence may include missed or late doses, treatment interruptions and discontinuations, and subtherapeutic or partial dosing.6,7 One of the major barriers to adherence among the pediatric population is the ability to swallow pills. This resource addresses the topic of adherence in children living with HIV.

 

HIV Drug Resistance

This resource describes the implications of HIV drug resistance and strategies for identifying and preventing drug resistance.

Adherence

HIV Drug Resistance

Pill Swallowing Education

HIV Treatment Guidelines

HIV Treatment Guidelines for pediatrics

HIV Treatment Guidelines for youth

Opportunistic Infection Guidelines

Opportunistic Infection Guidelines for pediatrics

Opportunistic Infection Guidelines for youth

Talking about HIV 

Disclosure

Disclosure includes informing a child of their own HIV status as well as informing partners. Disclosure to sexual partners is encouraged to improve treatment adherence, ability for seronegative partners to access potential prevention options, and some states may require disclosure prior to sexual activity. 8-10

 

Sexual Health

Discussing sexual health in Pediatric care is essential. This section provides a tool to support healthcare providers to better incorporate sexual health conversations and recommended preventive services into routine visits with adolescents and young adults.

The Importance of Disclosure

Sexual Health

References:

  1. Estimated HIV incidence and prevalence in the United States, 2015–2019 (cdc.gov)
  2. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data united states and 6 dependent areas, 2019. 2021. Available at: https://stacks.cdc.gov/view/cdc/156511
  3. Nesheim SR, Wiener J, Fitz Harris LF, Lampe MA, Weidle PJ. Brief report: estimated incidence of perinatally acquired HIV infection in the United States, 1978-2013. J Acquir Immune Defic Syndr. 2017;76(5):461-464. Available at: https://pubmed.ncbi.nlm.nih.gov/28991886/
  4. Sethi AK, Celentano DD, Gange SJ, et al. Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis. 2003; 37:1112–1118.
  5. Gardner EM, Burman WJ, Steiner JF, et al. Antiretroviral medication adherence and the development of class-specific antiretroviral resistance. AIDS. 2009;23:1035-1046.
  6. Vreeman RC, Nyandiko WM, Liu H, et al. Measuring adherence to antiretroviral therapy in children and adolescents in western Kenya. J Int AIDS Soc. 2014;17:19227. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25427633.
  7. Hawkins A, Evangeli M, Sturgeon K, Le Prevost M, Judd A, Aalphi Steering Committee. Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach. AIDS Care. 2016;28 Suppl 1:68-75. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26886514.
  8. World Health Organization. (‎2011)‎. Guideline on HIV disclosure counseling for children up to 12 years of age. World Health Organization. https://apps.who.int/iris/handle/10665/44777
  9. Finnegan A, Langhaug L, Schenk K, et. al. The prevalence and process of pediatric HIV disclosure: A population-based prospective cohort study in Zimbabwe. PLoS ONE. 2019; 14(5):e0215659
  10. Grainger C. Understanding disclosure behaviors in HIV-positive young people. J Infect Prev. 2017; 18(1):35-39.