The United States Department of Health and Human Services (DHHS)—a branch of the federal government that oversees health care policy in the United States—has published guidelines focusing on how best to treat HIV-infected children. These guidelines are important, as they help to make sure that all HIV-infected children in the United States are sufficiently cared for and treated.
The guidelines, which were updated in March 2009, are based on data collected from a number of studies—along with expert opinions—focusing on the importance of treating HIV-positive children, including the best time to start treatment and the best treatments to use.
The following table, based on DHHS recommendations, reviews when HIV treatment should be started by children living with HIV:
Age
Criteria
Recommendation
Infants younger than 12 months
Regardless of symptoms related to AIDS or an AIDS-defining illness, viral load, or CD4 cell count or percentage.
The child should be on treatment.
Children between 1 and 5 years of age
Symptoms related to AIDS or an HIV-related illness.
The child should be on treatment.
A CD4 percentage below 25 %, regardless of symptoms or viral load.
The child should be on treatment.
No (or only mild) symptoms related to AIDS or HIV and a CD4 percentage of 25% or higher and a viral load of 100,000 or higher.
Treatment should be considered.
No symptoms related to AIDS or an AIDS-defining illness and a CD4 percentage of 25% or higher and a viral load below 100,000
Hold off on therapy.
Children 5 years of age and older
Symptoms related to AIDS or an HIV-related illness.
No (or only mild) symptoms related to AIDS or HIV and a CD4 count of 350 or higher and a viral load of 100,000 copies or higher.
Treatment should be considered.
No symptoms related to AIDS or an AIDS-defining illness and a CD4 count of 350 or higher and a viral load below 100,000.
Hold off on therapy.
If you are caring for an HIV-positive child who is not being treated or have questions about starting your child on anti-HIV medications, be sure to discuss these issues with your child's pediatrician.
Once HIV treatment is started, the HIV-positive child will need to be monitored regularly to make sure that the medications are working well and not causing any serious side effects. If a significant problem arises while on therapy—such as a viral load becoming and/or remaining detectable, suppression of the immune system, symptoms of infection, slowed development of the central nervous system or growth failure —a switch in therapy might be necessary.
Search for news stories about this topic
