Sunday, March 20, 2011

Treating children for opportunistic infections

Treating children for opportunistic infections

Opportunistic infections, which take advantage of weak immune systems, are a serious threat to children living with HIV. Tuberculosis and PCP (a form of pneumonia) in particular are major causes of illness and death among infected infants.

Children are at particular risk of tuberculosis (TB), particularly if they are suffering from a weak immune system due to HIV infection and if their mother is infected.39 40 While the basic principles of TB treatment are the same in HIV-positive children and uninfected children, the situation is complicated by drug interactions between ARVs and drugs that are used to treat TB. Such interactions can lead to sub-therapeutic drug levels and an increased risk of toxic side effects. There are also drugs used for TB treatment specially formulated for children. For HIV-positive children who are not yet receiving ARVs, it is recommended that treatment for TB should ideally be initiated some weeks before ARV treatment, allowing the child to stabilise on this therapy. For children who are diagnosed with TB while already receiving treatment, ARV regimens need to be carefully reviewed, and may need to be adjusted in accordance with official guidelines.41 In order to avoid late diagnosis of HIV, it has been suggested that all TB-infected children should be considered for an HIV test.

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