Page 30 - Children Bookt.pdf

Table ( 8 ) : Recommendations for initiating ART in HIV-infected infants and
children according to clinical stage and immunological markers

Clinical stage Immunological

<24 months Treat all

>24 months Stage 4 a Treat all b

Stage 3 a Treat all

Stage 2
Treat if CD4 below age-adjusted threshold
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Stage 1

(a) Stabilize any opportunistic infection (OI) before initiating ART.
(b) Baseline CD4 is useful for monitoring ART even if it is not required to initiate ART.

Criteria for starting ART in infants and children less than 18 months with a
presumptive diagnosis of severe HIV disease 2

Where access to virological testing is not yet available, criteria for making a presumptive
diagnosis of severe HIV disease in children less than 18 months of age developed by
WHO can be used in order to allow initiation of potentially life-saving ART. Any

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antiretroviral therapy.
In infants and children who have been started on ART on the basis of a presumptive

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of HIV infection should be obtained as soon as possible using age-appropriate testing
methods. Additionally, HIV serological testing should be performed at 18 months

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treatment should be adjusted at that time in accordance with the results. ART should
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from an HIV-infected mother).
The initiation of ART on the basis of a presumptive diagnosis of severe HIV disease is
not recommended for use by providers who are not appropriately trained in HIV care
or the administration of ART. Presumptive diagnosis of severe HIV disease should not
be used in children aged 18 months and older as antibody testing establishes their HIV
infection status.

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