8.1 - Anti-Retroviral Therapy For Children Who Are ARV-Naive 2016

Principles of Therapy

1. Mono therapy or dual therapy is NO LONGER recommended as therapy for HIV infections.

2. Triple drug therapy is the standard treatment to avoid drug resistance and prolong of viral load suppression.

3. Dual NRTI remains the backbone of any regime, combined with another NNRTI or a PI.

4. Lamivudine and Abacavir remain the NRTI backbone of choice for most children based on favorable long-term follow up results.

5. Stavudine is no longer recommended due to its toxicities.

6. All PI should be Ritonavir-boosted (eg. LPV / RV as in Kaletra)

7. It is recommended that the HLA-B*5701 allele be screened before starting Abacavir to predict possible hypersensitivity reactions.

8. Nevirapine is the preferred NNRTI for children < 3 years and Efavirenz or Nevirapine for those > 3 years.

Updated: 06 December 2016