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the use of more than 1 antiretroviral medication.

D. Immunizations (refer to Chapter 18 for specific

information on childhood immunizations)

Immunization against childhood diseases is recommended for all children

exposed to and infected with HIV.
1. If a child has symptomatic HIV infection or has severe
immunosuppression, guidelines are as follows:
a. Only the inactivated influenza vaccine
that is given intramuscularly should be
used (influenza vaccine should be
given yearly).
b. Measles vaccine should not be given;
immunoglobulin may be prescribed
after measles exposure.
c. Only the inactivated polio vaccine that
is given intramuscularly should be
used.
d. Rotavirus vaccine should not be given.
e. Varicella-zoster virus vaccine should
not be given; varicella-zoster
immunoglobulin may be prescribed
after chickenpox exposure.
f. Tetanus immunoglobulin may be
prescribed for tetanus-prone wounds.
E. Caregiver instructions

1. Wash hands frequently.
2. Assess the child for fever, malaise, fatigue, weight loss,
vomiting, diarrhea, altered activity level, and oral
lesions; notify the pediatrician if any of these occur.
3. Assess the child for signs and symptoms of
opportunistic infections, such as pneumonia.
4. Administer antiretroviral medications and other
medications to the child as prescribed.
5. The child needs to be restricted from having contact
with persons who have infections or other contagious
or potentially contagious illnesses.
6. Keep the child’s immunizations up to date.
7. Keep the child home when sick.
8. Avoid direct unprotected contact with the child’s body
fluids.
9. Monitor the child’s weight.
10. Provide a high-calorie and high-protein diet to the
child.

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