HIV-infected children should be treated by a pediatrician who knows about HIV.
US Guidelines for ART in children were last updated in August 2010. They can be found on the Internet at http://www.aidsinfo.nih.gov/Guidelines/
Antiretroviral therapy (ART) works very well for children. The death rate of children with AIDS has dropped as much as for adults. However, manufacturers were not required to study their products in children until very recently in the US. Still, 17 ARVs are approved for use by children.
The best doses are not always known. Children’s doses are sometimes based on their weight. Another method is body surface area. This formula considers both height and weight. Sometimes, doses are recommended based on a child's development (Tanner stage.) As mentioned above, several factors affect drug levels in children. Dosing may have to be adjusted several times as a child develops.
The doses of some medications for infants and very young children can be individualized. They come in liquid or powder form. Others come in a granular form. Some pills can be crushed and added to food or liquids. Some clinics teach children how to swallow pills. Children who can swallow pills have more medication options.
Doctors sometimes try to cut adult tablets into smaller pieces for children. However, this can result in doses that are too low. Some tablets are difficult to cut. Also, the medication may be unevenly distributed in the tablet
It is difficult to know when to start treatment for children. Immediate treatment might prevent immune system damage. Delayed treatment may provide better quality of life for several years. However, HIV-related diseases show up much faster in untreated children than in adults. Without treatment, about 20% of children die or develop AIDS within one year.
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