HIV in Children

PROPHYLAXIS FOR PCP PNEUMONIA

Dr. Ira Shah
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Last Updated : 1st September 2012

Indications


  • 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
                     OR
4 mg/kg/day IV OD every 2-4 weeks
Alternate drug for children over 5 years of age
PROPHYLAXIS FOR PCP PNEUMONIA
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.