Managing HIV infection in infants, children and adolescents with HAART

Abstract

HIV continues to threaten the lives of millions of children worldwide. Despite the development of effective treatment, young infants, children and adolescents experience alarmingly high rates of morbidity and mortality without appropriate and timely implementation of combination antiretroviral therapy. Vertical transmission accounts for the majority of transmitted cases, reflecting the need for maternal screening and interventions during pregnancy and postnatally. Clinicians who care for infants and children with HIV infection encounter numerous challenges, including unpalatable formulations, lack of pediatric pharmacokinetic data, variable safety and efficacy profiles and reliance on a primary caregiver to administer complex drug regimens. The emergence of drug-resistant virus as a consequence of nonadherence is one of the leading causes of treatment failure and undermines future therapeutic options. Therefore, the purpose of this article is to address antiretroviral therapy management in infants, children and adolescents, and to present evidence-based data to optimize clinical practice.