Which antiretroviral drugs should be used?

Which antiretroviral drugs should be used?

As with adults, antiretroviral therapy with at least three drugs is recommended for children as this prevents HIV from becoming resistant to any single drug. It is usually recommended that this therapy should consist of two nucleoside reverse transcriptase inhibitors (NRTIs) combined with either one non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI).²² If a child has been exposed to NNRTIs during treatment to prevent mother-to-child transmission (common in most PMTCT interventions in developing countries) then his or her treatment should contain PIs. However, this not really feasible in most countries where the need for this treatment is greatest as PIs are expensive and have special storage requirements.

There are many factors that can influence the choice of drugs for children. Considerations about medications that the mother may have received during pregnancy, the toxicity of certain drugs, and whether the child is still breastfeeding, all need to be taken into account when choosing a regimen.