HIV in Children


Dr. Ira Shah
Last Updated : 1st September 2012


  • All HIV exposed infants from 4 weeks of age (Infants born to HIV infected mothers) till prove to be negative.
  • All HIV infected asymptomatic infants till 1 year of age
  • All symptomatic HIV infected children
  • After initial treatment for PCP
  • All HIV infected children with CD 4 % less than 15% irrespective of symptoms

How long to give prophylaxis

  • In HIV exposed infants till proved to be HIV negative
  • All HIV infected children who are symptomatic should receive till started on ART and there is evidence of immune reconstitution. i.e., in a CD 4 count of > 15% on 2 occasions no less than 3 months apart. If CD 4 count not available, then stop TMP/SMX only after 6 months of ART with clinical evidence of immune reconstitution.
  • All HIV infected children who do not receive ART and are symptomatic - prophylaxis should be continued indefinitely.

Dosage for PCP prophylaxis

Drugs Dosage Remarks
TMP/SMX 150 mg of TMPm2/day PO BD on alternate day
5 mg/kg of TMP/day PO HS daily
Drug of choice
Dapsone 2 mg/kg/day PO (max 100 mg/day) Alternative drug
Pentamidine 300 mg inhaler every 28 days
4 mg/kg/day IV OD every 2-4 weeks
Alternate drug for children over 5 years of age
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.