3.30 MB - Academy of Medicine of Malaysia

MANAGEMENT OF HIV INFECTION IN CHILDREN
GUIDELINE DEVELOPMENT AND OBJECTIVE
GUIDELINE DEVELOPMENT
The development group for this guideline comprised of paediatricians, a
family medicine specialist, a medical microbiologist and pharmacist, from
the Ministry of Health and the Ministry of Higher Education, Malaysia. During
the process of development of this guideline, there was active involvement
of a review committee which consisted of paediatricians from the public and
private sector together with a public health specialist and a clinical virologist.
This document is the first Clinical Practice Guideline (CPG) on the
Management of HIV infection in Children and Adolescents for Malaysia,
updating the 2nd Consensus Guideline (2001) and has been developed in
parallel with the CPG on Management of HIV Infection in Pregnancy.
Literature search was carried out at the following electronic databases,
International Health Technology Assessment Websites, PUBMED,
Cochrane Database of Systemic Reviews (CDSR) Journal full text via the
OVID search engine, Comprehensive; Database of Abstracts of Reviews of
Effectiveness; Cochrane Controlled Trials Registered, Clinical Trial Registry
and EBSCO search engine. MEDLINE search was limited to children "all
child" (0-18 years). References from relevant articles retrieved were
searched to identify further studies. The following free text terms or MeSH
term were used either singly or in combination: "HIV infection, mother-tochild-transmission,
perinatal HIV infection, antiretroviral therapy, side
effects, co-infections, tuberculosis, toxoplasmosis, syphilis, hepatitis B
infection, hepatitis C infection, cytomegalovirus infection, human
immunodeficiency virus, diagnosis, HIV DNA PCR, HIV RNA assays,
infants, breastfeeding, infant feeding, HIV prophylaxis AND cotrimoxazole,
HIV prophylaxis AND pneumocystis, AIDS-Related Opportunistic Infections
AND Trimethoprim-Sulfamethoxazole; combination, "immunisation"
"vaccination" and BCG, hepatitis B, diphtheria, pertussis, tetanus, polio
(oral and injectable), Haemophilus influenzae type B, measles, mumps,
rubella, meningococcal, pneumococcal and varicella; antiretroviral, HAART,
therapy, initiate, start, commence, "begin" (in various combinations), HIV
AND cardiac ; HIV AND neurology; HIV AND lung; HIV AND renal; HIV AND
oncology; HIV transmitted resistance', 'primary resistance', 'HIV treatment
naïve', “plasma decay HIV”, “HIV immunologic response”, “virologic
response”, “HIV treatment response”, “monitoring”, 'adherence', and 'immune
reconstitution syndrome'.
Reference was also made to other guidelines on management which included
the Public Health Service Task Force Recommendations for Use of
Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health
and Interventions to Reduce Perinatal HIV Transmission in the United States
(November 2, 2007), US Department of Health & Human Services
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