Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010
With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less t...
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| Veröffentlicht in: | Asian biomedicine 2010-08, Vol.4 (4), p.505-513 |
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| creator | Puthanakit, Thanyawee Tangsathapornpong, Auchara Ananworanich, Jintanat Wongsawat, Jurai Suntrattiwong, Piyarat Wittawatmongkol, Orasri Mekmullica, Jutarat Waidab, Woraman Bhakeecheep, Sorakij Chokephaibulkit, Kulkanya |
| description | With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less than 12 months of age at any CD4 level regardless of symptoms and in all children at CDC clinical stage B and C or WHO clinical stages 3 and 4. For children with no or mild symptoms consider CD4-guided thresholds of CD4 |
| doi_str_mv | 10.2478/abm-2010-0065 |
| format | Article |
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(children 5 years or older). The preferred first-line regimen in children aged < 3 years is AZT+3TC+NVP. For children >3 years of age the preferred regimen is AZT+3TC+EFV. If an infant has previously been exposed to NVP perinatally, use AZT+3TC+LPV/r as empirical first regimen. In adolescents, consider TDF+3TC+EFV. The preferred ARV treatment in children who failed first line regimens of 2NRTI+NNRTI (Salvage treatment) comprises 2NRTI (guided by genotype) +LPV/r, and an alternative regimen is 2NRTI (guided by genotype) +ATV/ r (use in cases with dyslipidemia who are six years or older). In cases with extensive NRTI resistance with no effective NRTI option available, double boosted PI with LPV/r+SQV or LPV/r+IDV can be considered. Consultation with an expert is recommended. Laboratory monitoring is recommended for CD4 and every six months. Viral load at least at 6 and 12 months after initiation or change of regimen, then yearly thereafter. More frequent viral load monitoring is advised for cases with unsuccessful virologic response, infants, children with imperfect adherence, or those using of third line regimens. Toxicity monitoring depends on the drug received, at least every six months, and more often as clinically indicated. These include, but are not limited to, complete blood count, renal function tests, liver function tests, urinanalysis, and lipid profiles. Therapeutic drug monitoring is recommended in cases that have ARV-related toxicity, receiving non-standard dosing or regimens, using double boosted PI, and in those with renal or hepatic impairment.</description><identifier>ISSN: 1875-855X</identifier><identifier>ISSN: 1905-7415</identifier><identifier>EISSN: 1875-855X</identifier><identifier>DOI: 10.2478/abm-2010-0065</identifier><language>eng</language><publisher>Bangkok: De Gruyter Open</publisher><subject>HIV ; Human immunodeficiency virus ; pediatrics ; Thai guidelines ; Toxicity</subject><ispartof>Asian biomedicine, 2010-08, Vol.4 (4), p.505-513</ispartof><rights>2010. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c355t-62a47f0cbd48cf3b82c511784fcca635d4a45a0c279bd593a5d78da8e2c06de83</citedby><cites>FETCH-LOGICAL-c355t-62a47f0cbd48cf3b82c511784fcca635d4a45a0c279bd593a5d78da8e2c06de83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Puthanakit, Thanyawee</creatorcontrib><creatorcontrib>Tangsathapornpong, Auchara</creatorcontrib><creatorcontrib>Ananworanich, Jintanat</creatorcontrib><creatorcontrib>Wongsawat, Jurai</creatorcontrib><creatorcontrib>Suntrattiwong, Piyarat</creatorcontrib><creatorcontrib>Wittawatmongkol, Orasri</creatorcontrib><creatorcontrib>Mekmullica, Jutarat</creatorcontrib><creatorcontrib>Waidab, Woraman</creatorcontrib><creatorcontrib>Bhakeecheep, Sorakij</creatorcontrib><creatorcontrib>Chokephaibulkit, Kulkanya</creatorcontrib><title>Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010</title><title>Asian biomedicine</title><description>With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less than 12 months of age at any CD4 level regardless of symptoms and in all children at CDC clinical stage B and C or WHO clinical stages 3 and 4. For children with no or mild symptoms consider CD4-guided thresholds of CD4 <25% (children aged one to five years) or CD4 <350 cells/mm
(children 5 years or older). The preferred first-line regimen in children aged < 3 years is AZT+3TC+NVP. For children >3 years of age the preferred regimen is AZT+3TC+EFV. If an infant has previously been exposed to NVP perinatally, use AZT+3TC+LPV/r as empirical first regimen. In adolescents, consider TDF+3TC+EFV. The preferred ARV treatment in children who failed first line regimens of 2NRTI+NNRTI (Salvage treatment) comprises 2NRTI (guided by genotype) +LPV/r, and an alternative regimen is 2NRTI (guided by genotype) +ATV/ r (use in cases with dyslipidemia who are six years or older). In cases with extensive NRTI resistance with no effective NRTI option available, double boosted PI with LPV/r+SQV or LPV/r+IDV can be considered. Consultation with an expert is recommended. Laboratory monitoring is recommended for CD4 and every six months. Viral load at least at 6 and 12 months after initiation or change of regimen, then yearly thereafter. More frequent viral load monitoring is advised for cases with unsuccessful virologic response, infants, children with imperfect adherence, or those using of third line regimens. Toxicity monitoring depends on the drug received, at least every six months, and more often as clinically indicated. These include, but are not limited to, complete blood count, renal function tests, liver function tests, urinanalysis, and lipid profiles. Therapeutic drug monitoring is recommended in cases that have ARV-related toxicity, receiving non-standard dosing or regimens, using double boosted PI, and in those with renal or hepatic impairment.</description><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>pediatrics</subject><subject>Thai guidelines</subject><subject>Toxicity</subject><issn>1875-855X</issn><issn>1905-7415</issn><issn>1875-855X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkM1LAzEQxYMoWKtH7wHPq8luspt6k6K2UPBSxVuYzUebst1dk6zS_94sFfTgaYaZ3zzePISuKbnNWSXuoN5nOaEkI6TkJ2hCRcUzwfn76Z_-HF2EsEtETqmYIFhvweEWoutaaPBmcNo0rjUB287juDV4CAZ3FkMbnTfRd5_OJzBtPPQH7FrcG-0geqfwYvmWBtaoUW1cjW4u0ZmFJpirnzpFr0-P6_kiW708L-cPq0wVnMeszIFVlqhaM6FsUYtccUorwaxSUBZcM2AciMqrWa35rACuK6FBmFyRUhtRTNHNUbf33cdgQpS7bvDpqSALyotZ-peXicqOlPJdCN5Y2Xu3B3-QlMgxRZlSlKNvOaaY-Psj_wVNNF6bjR8OqfkV__eOMU548Q1UK3jL</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Puthanakit, Thanyawee</creator><creator>Tangsathapornpong, Auchara</creator><creator>Ananworanich, Jintanat</creator><creator>Wongsawat, Jurai</creator><creator>Suntrattiwong, Piyarat</creator><creator>Wittawatmongkol, Orasri</creator><creator>Mekmullica, Jutarat</creator><creator>Waidab, Woraman</creator><creator>Bhakeecheep, Sorakij</creator><creator>Chokephaibulkit, Kulkanya</creator><general>De Gruyter Open</general><general>De Gruyter Poland</general><scope>AAYXX</scope><scope>CITATION</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20100801</creationdate><title>Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010</title><author>Puthanakit, Thanyawee ; Tangsathapornpong, Auchara ; Ananworanich, Jintanat ; Wongsawat, Jurai ; Suntrattiwong, Piyarat ; Wittawatmongkol, Orasri ; Mekmullica, Jutarat ; Waidab, Woraman ; Bhakeecheep, Sorakij ; Chokephaibulkit, Kulkanya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c355t-62a47f0cbd48cf3b82c511784fcca635d4a45a0c279bd593a5d78da8e2c06de83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>pediatrics</topic><topic>Thai guidelines</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Puthanakit, Thanyawee</creatorcontrib><creatorcontrib>Tangsathapornpong, Auchara</creatorcontrib><creatorcontrib>Ananworanich, Jintanat</creatorcontrib><creatorcontrib>Wongsawat, Jurai</creatorcontrib><creatorcontrib>Suntrattiwong, Piyarat</creatorcontrib><creatorcontrib>Wittawatmongkol, Orasri</creatorcontrib><creatorcontrib>Mekmullica, Jutarat</creatorcontrib><creatorcontrib>Waidab, Woraman</creatorcontrib><creatorcontrib>Bhakeecheep, Sorakij</creatorcontrib><creatorcontrib>Chokephaibulkit, Kulkanya</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Asian biomedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Puthanakit, Thanyawee</au><au>Tangsathapornpong, Auchara</au><au>Ananworanich, Jintanat</au><au>Wongsawat, Jurai</au><au>Suntrattiwong, Piyarat</au><au>Wittawatmongkol, Orasri</au><au>Mekmullica, Jutarat</au><au>Waidab, Woraman</au><au>Bhakeecheep, Sorakij</au><au>Chokephaibulkit, Kulkanya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010</atitle><jtitle>Asian biomedicine</jtitle><date>2010-08-01</date><risdate>2010</risdate><volume>4</volume><issue>4</issue><spage>505</spage><epage>513</epage><pages>505-513</pages><issn>1875-855X</issn><issn>1905-7415</issn><eissn>1875-855X</eissn><abstract>With better knowledge and availability of antiretroviral treatments, the Thai National HIV Guidelines Working Group has issued treatment guidelines for children in Thailand in March 2010. The most important aspects of these new guidelines are detailed below. ART should be initiated in infants less than 12 months of age at any CD4 level regardless of symptoms and in all children at CDC clinical stage B and C or WHO clinical stages 3 and 4. For children with no or mild symptoms consider CD4-guided thresholds of CD4 <25% (children aged one to five years) or CD4 <350 cells/mm
(children 5 years or older). The preferred first-line regimen in children aged < 3 years is AZT+3TC+NVP. For children >3 years of age the preferred regimen is AZT+3TC+EFV. If an infant has previously been exposed to NVP perinatally, use AZT+3TC+LPV/r as empirical first regimen. In adolescents, consider TDF+3TC+EFV. The preferred ARV treatment in children who failed first line regimens of 2NRTI+NNRTI (Salvage treatment) comprises 2NRTI (guided by genotype) +LPV/r, and an alternative regimen is 2NRTI (guided by genotype) +ATV/ r (use in cases with dyslipidemia who are six years or older). In cases with extensive NRTI resistance with no effective NRTI option available, double boosted PI with LPV/r+SQV or LPV/r+IDV can be considered. Consultation with an expert is recommended. Laboratory monitoring is recommended for CD4 and every six months. Viral load at least at 6 and 12 months after initiation or change of regimen, then yearly thereafter. More frequent viral load monitoring is advised for cases with unsuccessful virologic response, infants, children with imperfect adherence, or those using of third line regimens. Toxicity monitoring depends on the drug received, at least every six months, and more often as clinically indicated. These include, but are not limited to, complete blood count, renal function tests, liver function tests, urinanalysis, and lipid profiles. Therapeutic drug monitoring is recommended in cases that have ARV-related toxicity, receiving non-standard dosing or regimens, using double boosted PI, and in those with renal or hepatic impairment.</abstract><cop>Bangkok</cop><pub>De Gruyter Open</pub><doi>10.2478/abm-2010-0065</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | HIV Human immunodeficiency virus pediatrics Thai guidelines Toxicity |
| title | Thai national guidelines for the use of antiretroviral therapy in pediatric HIV infection in 2010 |
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