3.30 MB - Academy of Medicine of Malaysia

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MANAGEMENT OF HIV INFECTION IN CHILDREN ALGORITHM 1-MANAGEMENT OF HIV EXPOSED INFANTS Mother - HIV positive • Initiate HIV prophylaxis in newborn immediately after delivery - Scenario 1+2: ZDV 2mg/kg/dose qid X 6/52 OR 4mg/kg/dose bd x 6/52 - Scenario 3+4: sd NVP 2 mg/kg + ZDV 2mg/kg/dose qid x6/52 OR 4mg/kg/dose bd x 6/52 • HIV DNA PCR (together with mothers blood) at 0-2 weeks • FBC at birth and 6/52 • Start PCP prophylaxis at 6/52 till HIV status determined (Co- trimoxazole - 4mg TMP / 20mg SMX/ kg daily or 150 mg TMP/ 750 SMX mg /m 2 /day divided twice daily for 3 days per week) PCR Positive ( +ve) Repeat HIV DNA PCR as soon as possible PCR +ve Infected • PCP Prophylaxis up to 12 months (Then evaluate for continued need) • ART if indicated • Follow up PCR +ve viii 9 PCR +ve PCR +ve PCR Negative ( -ve ) Repeat HIV PCR at 6 weeks <strong>of</strong> age PCR -ve Repeat HIV PCR at 4- 6 months PCR -ve Not infected • Stop co-trimoxazole • 3 months follow-up until 18 months • Ensure that the baby's antibody status is negative by 18 months • Then yearly follow - up until adulthood Foot note: Scenario 1- HIV -infected pregnant mother who is already on HAART Scenario 2- HIV- infected pregnant mother who has been started on ZDV (between 14-28 weeks) Scenario 3- HIV -infected pregnant mother at delivery who has not received adequate ART (less than 4 weeks) Scenario 4 - Infant born to HIV -infected mother who has not received any ART * For babies found abandoned at birth, the algorithm above is applied according to the rapid HIV test result while awaiting confirmation
MANAGEMENT OF HIV INFECTION IN CHILDREN ALGORITHM 2- MEDICAL MANAGEMENT OF HIV POSITIVE MOTHER HIV POSITIVE MOTHER On HAART Diagnosed in labour no prior therapy Newly Diagnosed/ Not on ART CD4
Page 2 and 3: This Guideline is intended a guide
Page 4 and 5: MANAGEMENT OF HIV INFECTION IN CHIL
Page 8 and 9: REVIEW COMMITTEE The draft guidelin
Page 12 and 13: TABLE OF CONTENTS MANAGEMENT OF HIV
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MANAGEMENT OF HIV INFECTION IN CHIL
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71 Appendix 2 WHO CLINICAL STAGING
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Appendix 6 MANAGEMENT OF HIV INFECT
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Appendix 7 MANAGEMENT OF HIV INFECT
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3.30 MB - Academy of Medicine of Malaysia

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