Page 3 - Children Bookt.pdf

NATIONAL AIDS PROGRAMME DEPARTMENT OF HEALTH, MINISTRY OF HEALTH, MYANMAR 2011

Contents

List of Abbreviations iii
List of participants attending Workshop on New ART Guidlines v
List of Peer Review Team Members vi

Introduction 1
1. Diagnosis of HIV infection in children 3
Clinical recognition of symptomatic HIV infection in children 3
Laboratory Diagnosis of HIV infection in children 4

2. Management of children born to HIV- infected mothers 9
Infant feeding counselling 9
Family education, counselling and support 9

3. HIV staging in children using clinical and immunological criteria 11
Using clinical criteria 11
Using Immunological Criteria (Using CD4 and Total Lymphocyte count) 11

4. Cotrimoxazole prophylaxis for Pneumocystis Jiroveci Pneumonia (PCP) 13
Initiating co-trimoxazole prophylaxis 13
HIV exposed infants and children 14
Infants and children with documented HIV-infection 14
Discontinuation of cotrimoxazole prophylaxis 15
Secondary cotrimoxazole prophylaxis in infants and children 15

5. Immunization schedule for HIV-exposed or HIV-infected children 17

6. Management of HIV-infected children 19

7. Starting ART 21
Conditions necessary to introduce antiretroviral therapy 21
Starting ART using clinical and CD4 criteria 21
Criteria for starting ART in infants and children less than 18 months with
a presumptive diagnisis of severe HIV disease 22

Infants and children <24 months 25

!
"

#$

%! !
&&

#

10. Adherence assessment and strategies to improve adherence 31

i