HIV in Children

PROPHYLAXIS FOR CYTOMEGALOVIRUS INFECTION (CMV)

Dr. Ira Shah
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Last Updated : 1st September 2012

Primary prophylaxis


All HIV infected children with severe immunosuppression (CD 4 count < 50 cells/cumm) may be considered for primary prophylaxis against CMV. However it is not routinely recommended.

Secondary prophylaxis


Life-long maintenance therapy following treatment for CMV disease is recommended. Maintenance therapy may be discontinued in patients on HAART who have an increase in CD 4 count to > 100-150 cells/cumm after 6 months of therapy. All patients who have had maintenance therapy discontinued should undergo 6 monthly ophthalmologic evaluation for evidence of chorioretinitis.

Drugs that can be used


Drug Dosage Adverse Effects Remarks
Oral ganciclovir 30 mg/kg PO TID Neutropenia, Myelosuppression, Renal toxicity, CNS effects, GI dysfunction, thrombophlebitis and elevated liver enzymes Drug of choice
Oral valganciclovir 250 mg/m2/day PO OD Myelosuppression Data in children is lacking


PROPHYLAXIS FOR CYTOMEGALOVIRUS INFECTION (CMV)
Dr. Ira Shah
Incharge Pediatric HIV and TB Clinic, B.J.Wadia Hospital for Children, Mumbai, India Consultant in Pediatric Infectious Diseases, Nanavati Hospital, Mumbai, India.
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