Update to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV
Cross-posted from Clinicalinfo
The Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV (Pediatric Opportunistic Infection Guidelines) have been updated.
Major revisions within the last six months are as follows:
- Updated information on the epidemiology of antifungal-resistant Candida, including Candida auris.
- Recommended posaconazole as an alternative therapy for fluconazole-refractory oropharyngeal candidiasis in children.
- Added isavuconazole as an alternative therapy for fluconazole-refractory esophageal candidiasis.
- Added information on the recommended management of Candida infections of the central nervous system.
- Emphasized the importance of antiretroviral therapy for all infants and children with HIV and candidiasis.
- Updated the vaccine section to include information and recommendations on the nonavalent human papillomavirus (HPV) vaccine.
- Added a section on HPV vaccine efficacy.
- Expanded the section on treating HPV-associated warts, providing more detail on treatment considerations for children compared with considerations for older patients.
- Updated the age-specific criteria for discontinuing primary prophylaxis.
- Added guidance on Pneumocystis jirovecii pneumonia prophylaxis in breastfed infants with perinatal HIV exposure.
- Added intravenous pentamidine as an alternative regimen for primary prophylaxis.
- Added twice-daily dosing of atovaquone as an option for children aged 1 month to 12 years.
- Added information on the clinical manifestations of ocular toxoplasmosis.
- Updated the age-specific criteria for discontinuing and restarting primary and secondary prophylaxis.
- Updated the dosing recommendation for sulfadiazine secondary prophylaxis.
- Updated information on the preferred acute induction therapy regimen for treating acquired toxoplasmosis.
All updates are developed by the subject matter groups listed in Appendix C of the guidelines and reviewed by editors and relevant outside reviewers before finalization.
For a list of recent updates, please see What's New in the Guidelines. To view or download the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV, go to the Clinicalinfo website. The guidelines tables and recommendations also can be downloaded as separate PDF files.
Clinicalinfo welcomes your feedback on the latest revisions to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV. Please send your comments with the subject line “Pediatric Opportunistic Infections Guidelines” to HIVinfo@NIH.gov by January 12, 2025.