Page 47 - Children Bookt.pdf

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attributable to an ARV drug or drugs, or to a non-ARV medication taken at the
same time.
Consider other disease processes (e.g. viral hepatitis in a child on ARV drugs who
develops jaundice). Not all problems that arise during treatment are caused by
ARV drugs.
Manage the adverse reaction according to its severity
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(a) Severe life-threatening reactions: Immediately discontinue all ARV drugs,
manage the medical event (i.e. provide symptomatic and supportive therapy)

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substitution for the offending drug) when the patient is stabilized.
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(b) Severe reactions: Substitute the offending drug without stopping ART.
(c) Moderate reactions: Consider continuation of ART as long as feasible. If
the patient does not improve on symptomatic therapy, consider single-drug
substitution. a
(d) Mild reactions: Reassure child and caregiver that while the reaction may be
bothersome, it does not require a change in therapy; provide counselling and
support to mitigate adverse reactions.

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reactions.

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Principles
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life-threatening, as there are few ARV options for children in resource-limited
settings.
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can generally be replaced with another drug from the same class that does not
have the same adverse effect.

Given the limited number of ARV drug options available in resource-limited

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life-threatening.
Table (13) lists the usual ARV substitution options for adverse reactions among the

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