current research and information 3 -HIV and AIDS

HIV and AIDS Information
Current research and information - page 3

HIV/AIDS in Children

HIV in Pregnancy and Perinatal HIV

HIV Infection in Women

HIV/AIDS in Children

The general principles of therapy in HIV-infected adults, adolescents and children are similar but there are many unique aspects that are covered in these specific paediatric references.

Pediatric Guidelines: Guidelines for use of antiretroviral agents in pediatric HIV is a comprehensive guideline on the use of antiretroviral drugs in HIV infected children and infants. It is an essential tool for any medical professional caring for children with HIV infection.

The American Academy of Pediatrics has written a number of statements on specific issues around HIV in children which are published intermittently in the journal Pediatrics. They are available from:
www.aap.org/

Once in this website enter 'HIV" into the search engine.

HIV in Pregnancy and Perinatal HIV

These following two guidelines are very similar, with one from the British HIV Association and the other the United States Public Health Service task force.

The British guidelines cover areas such as discordant couples and psychological issues and have 'levels of evidence'. The United States guidelines are a complete review of antiretroviral therapy in pregnant HIV infected women as well as mode of delivery. Both cover issues for the neonate. At least one of these is essential reading for the medical professional directly involved in the care of an HIV-infected pregnant women.

www.bhiva.org
Guidelines for the management of HIV infection in pregnant women and the prevention of mother-to-child transmission (British HIV Association). These guidelines are not available online.

Guidelines: Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and Interventions to reduce perinatal HIV-1 transmission in the United States.

HIV Infection in Women

Several early studies suggested a more aggressive natural history of HIV infection in women with shortened survival times but more recent studies have found the rate of clinical progression is similar between men and women if they receive comparable care. Currently, recommended treatment guidelines are identical for men and women eg, DHHS Guidelines for using Antiretroviral Agents among HIV-infected Adults and Adolescents: the Panel on Clinical Practices for HIV

The Sanford Guide to HIV/AIDS Therapy, 2002 (11th ed) Sande M, Gilbert D, Moellering R gives a succinct overview of the particular issues for women with HIV infection. It can be purchased from:
www.sanfordguide.com

The same issues are also covered by a very practical review article which emphasises that gynaecological infection is the most common reason for initial medical presentation in HIV positive women. Evaluation and Management of HIV-Infected Women, Levine MA is available from:
www.annals.org/issues/v136n3/full/200202050-00011.html

The US CDC guidelines recommend a cervical smear test should be obtained twice in the first year after diagnosis of HIV infection and, if the results are normal, annually thereafter. HIV infection is not an indication for colposcopy in positive women who have normal smear test results.
www.cdc.gov/STD/treatment/6-2002TG.htm#CervicalCancerScreening

In New Zealand, the National Cervical Screening Programme also recommends annual cervical smears for women with HIV infection. If the smear results are abnormal, care should be provided according to the National Cervical Screening Programme: Guidelines for the Management of Women with Abnormal Cervical Smears.

www.nsu.govt.nz

www.nzgg.org.nz