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Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

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Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children Recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics (This guideline was simultaneously published in The Pediatric Infectious Disease Journal on November 6, 2013.) Prepared by George K. Siberry MD, MPH, Executive Edward Handelsman MD;1,§ Secretary;1 Lynne M. Mofenson MD;1 Mark J. Abzug MD, Co-Chair;2 Steve Nesheim MD;5 Sharon Nachman MD, Co-Chair;3 and the Panel on Opportunistic Infections in HIV- Michael T. Brady MD;4 Exposed and HIV-Infected Children* Kenneth L. Dominguez MD, MPH;5 1National Institutes of Health, Bethesda, Maryland 2University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado 3State University of New York at Stony Brook, Stony Brook, New York 4Nationwide Children’s Hospital, Columbus, Ohio 5Centers for Disease Control and Prevention, Atlanta, Georgia * Panel member authors (in alphabetical order): Debika Bhattacharya, MD; Beverly Bohannon, MS, RN; Diana Clarke, Pharm. D.; Kathryn M. Edwards, MD; Jennifer C. Esbenshade, MD, MPH; Patricia Flynn, MD; Aditya Gaur, MD; Francis Gigliotti, MD; Gail Harrison, MD; Charlotte Victoria Hobbs, MD; David Kimberlin, MD; Martin B. Kleiman, MD; Emilia H. Koumans, MD, MPH; Andrew Kroger, MD, MPH; Myron J. Levin. MD; Cara L. Mack, MD; Ben J. Marais, MD; Gabriela Maron, MD; James McAuley, MD, MPH; Heather J. Menzies, MD, MPH; Anna-Barbara Moscicki, MD; Michael R. Narkewicz, MD; Richard Rutstein, MD; Jane Seward, MBBS, MPH; Masako Shimamura, MD; William J. Steinbach, MD; Gregory J. Wilson, MD. § Dr. Handelsman, Branch Chief of the Maternal, Adolescent, and Pediatric Research Branch of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, died unexpectedly on March 5, 2012.Dr. Handelsman was a pediatrician dedicated to the care of HIV-infected infants, children, adolescents, and pregnant women whose work and advocacy saved the lives and improved the health of thousands of children around the world. How to Cite the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children: Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/ oi_guidelines_pediatrics.pdf. Section accessed [insert date] [insert page number, table number, etc., if applicable] It is emphasized that concepts relevant to HIV management evolve rapidly. The Panel has a mechanism to update recommendations on a regular basis, and the most recent information is available on the AIDSinfo website Access AIDSinfo (http://aidsinfo.nih.gov). mobile site Table of Contents Summary.......................................................................................................................................................A-1 Background and Recommendations Rating Scheme ................................................................................B-1 Preventing Vaccine-Preventable Diseases in HIV-Infected Children and Adolescents..........................C-1 Bacterial Infections ......................................................................................................................................D-1 Candida Infections ........................................................................................................................................E-1 Coccidioidomycosis.......................................................................................................................................F-1 Cryptococcosis ..............................................................................................................................................G-1 Cryptosporidiosis .........................................................................................................................................H-1 Cytomegalovirus ............................................................................................................................................I-1 Giardiasis........................................................................................................................................................J-1 Hepatitis B Virus ..........................................................................................................................................K-1 Hepatitis C Virus...........................................................................................................................................L-1 Herpes Simplex Virus Infections................................................................................................................M-1 Histoplasmosis ..............................................................................................................................................N-1 Human Herpesvirus 8 Disease ....................................................................................................................O-1 Human Papillomavirus.................................................................................................................................P-1 Influenza........................................................................................................................................................Q-1 Isosporiasis (Cystoisosporiasis) ...................................................................................................................R-1 Malaria...........................................................................................................................................................S-1 Microsporidiosis ............................................................................................................................................T-1 Mycobacterium avium Complex Disease.....................................................................................................U-1 Mycobacterium tuberculosis .........................................................................................................................V-1 Pneumocystis jirovecii Pneumonia..............................................................................................................W-1 Progressive Multifocal Leukoencephalopathy...........................................................................................X-1 Syphilis...........................................................................................................................................................Y-1 Toxoplasmosis................................................................................................................................................Z-1 Varicella-Zoster Virus ...............................................................................................................................AA-1 Appendix 1. Important Guideline Considerations..................................................................................BB-1 Appendix 2. Panel Members.....................................................................................................................CC-1 Appendix 3. Financial Disclosures ...........................................................................................................DD-1 Table 1: Primary Prophylaxis ...................................................................................................................EE-1 Guidelines for the Prevention and Treatment of Opportunistic Infections In HIV-Exposed and HIV-Infected Children i Table 2: Secondary Prophylaxis ................................................................................................................FF-1 Table 3: Treatment ....................................................................................................................................GG-1 Table 4. Common Drugs Used for Treatment of Opportunistic Infections in HIV-Infected Children: Preparations and Major Toxicities .............................................................HH-1 Table 5: Significant Drug Interactions for Drugs Used to Treat or Prevent Opportunistic Infections................................................................................................................II-1 Figure 1. Recommended Immunization Schedule for HIV-Infected Children Aged 0–6 years—United States, 2013.........................................................................................................JJ-1 Figure 2. Recommended Immunization Schedule for HIV-Infected Children Aged 7–18 years—United States, 2013 ....................................................................................................KK-1 Guidelines for the Prevention and Treatment of Opportunistic Infections In HIV-Exposed and HIV-Infected Children ii Summary (Last updated November 6, 2013; last reviewed November 6, 2013) This report updates the last version of the Guidelines for the Prevention and Treatment of Opportunistic Infections (OIs) in HIV-Exposed and HIV-Infected Children, published in 2009. These guidelines are intended for use by clinicians and other health-care workers providing medical care for HIV-exposed and HIV-infected children in the United
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