Loading ...
Sorry, an error occurred while loading the content.

WHO guidelines for the use of ART in children

Expand Messages
  • AIDS INDIA
    WHO guidelines for the use of ART in children Antiretroviral therapy of HIV infection in infants and children in resource-limited settings: towards universal
    Message 1 of 2 , Sep 1, 2006
    View Source
    • 0 Attachment
      WHO guidelines for the use of ART in children

      Antiretroviral therapy of HIV infection in infants and children in
      resource-limited settings: towards universal access: Recommendations
      for a public health approach

      The most efficient and cost-effective way to tackle paediatric HIV
      globally is to reduce mother-to-child transmission (MTCT). However,
      every day there are nearly 1500 new infections in children under 15
      years of age, more than 90% of them occurring in the developing
      world and most being associated with MTCT (1). HIV-infected infants
      frequently present with clinical symptoms in the first year of life,
      and by one year of age an estimated one-third of infected infants
      will have died, and about half by 2 years of age (2, 3). There is
      thus a critical need to provide antiretroviral therapy (ART) for
      infants and children who become infected despite the efforts being
      made to prevent such infections.

      In countries where it has been successfully introduced, ART has
      substantially changed the face of HIV infection. HIV-infected
      infants and children now survive to adolescence and adulthood. The
      challenges of providing HIV care have therefore evolved to become
      those of chronic as well as acute care. In resource-limited
      settings, many of which are countries hardest hit by the epidemic,
      unprecedented efforts made since the introduction of the `3 by 5'
      targets and global commitments to rapidly scale up access to ART
      have led to remarkable progress. However, this urgency and intensity
      of effort have met with less success in extending the provision of
      ART to HIV-infected children. Significant obstacles to scaling up
      paediatric care remain, including limited screening for HIV, a lack
      of affordable simple diagnostic testing technologies, a lack of
      human capacity, insufficient advocacy and understanding that ART is
      efficacious in children, limited experience with simplified
      standardized treatment guidelines, and a lack of affordable
      practicable paediatric antiretroviral (ARV) formulations.
      Consequently, far too few children have been started on ART in
      resource-limited settings. Moreover, the need to treat an increasing
      number of HIV-infected children highlights the primary importance of
      preventing the transmission of the virus from mother to child in the
      first place.

      WHO guidelines for the use of ART in children were considered within
      the guidelines for adults published in 2004 (4). Revised, stand-
      alone comprehensive guidelines based on a public health approach
      have been developed in order to support and facilitate the
      management and scale-up of ART in infants and children.

      The present guidelines are part of WHO's commitment to achieve
      universal access to ART by 2010. Related publications include the
      revised treatment guidelines for adults (i.e. the 2006 revision),
      revised guidelines on ARV drugs for treating pregnant women and
      preventing HIV infection in infants, guidelines on the use of co-
      trimoxazole preventive therapy (CPT),(i) and revised WHO clinical
      staging for adults and children (5). (i) These three documents are
      currently in preparation and are expected to be published by WHO in
      2006.

      Download file in English [pdf 1.54Mb]
      http://www.who.int/hiv/pub/guidelines/WHOpaediatric.pdf
    • Prayas- Pune
      Dear forum members, It is good to receive such guidelines from time to time and thus we all should welcome the initiative from WHO. It helps clinicians monitor
      Message 2 of 2 , Sep 2, 2006
      View Source
      • 0 Attachment
        Dear forum members,

        It is good to receive such guidelines from time to time and thus we all should welcome the initiative from WHO. It helps clinicians monitor themselves in the absence of any national guidelines.

        The original mail brings out a point for critical discussion.

        As is mentioned by the author the most efficient and cost-effective way to tackle paediatric HIV globally is to reduce mother-to-child transmission (MTCT).

        In keeping with this WHO has also recently published its new guidelines for PMTCT (August 2006). These are a modification over the last year's WHO guidelines.

        For us in India, the NACO guidelines last published (and thus the only ones available today) are the only guiding principles. They are still different from the WHO guidelines. Given the resources, expertize and reasonably strong network of public health care facilities in India, we feel, India should be adopting more effective regimens and not the ones which have less efficiency, even in the public sector.

        We are waiting for NACO to provide us with updated guidelines.

        PRAYAS
        Pune
        e-mail: <prayashealth@...>
      Your message has been successfully submitted and would be delivered to recipients shortly.