Update to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV
The Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV (Pediatric Opportunistic Infection Guidelines) have been updated.
Major revisions within the last six months are as follows:
Updated areas impacted by Coccidioides spp.
Recommended liposomal amphotericin as the preferred regimen for treatment of severe illness due to diffuse pulmonary or disseminated non-meningitic disease
Added isavuconazole as an option for salvage therapy
Updated indications and dosing recommendations for revaccination against hepatitis B virus (HBV)
Updated recommended treatment options for HBV infection, including the addition of tenofovir alafenamide and the removal of interferon-alfa and adefovir
Added screening recommendations for hepatocellular carcinoma
Added recommendations regarding immunizations for COVID-19, respiratory syncytial virus, dengue, and mpox
Updated pneumococcal conjugate vaccine recommendations to include 15-valent and 20-valent pneumococcal conjugate (PCV15 and PCV20) vaccines
Added catch-up immunization information for inactivated poliovirus vaccine (IPV)
Added hepatitis A (HepA) vaccine and measles, mumps, and rubella (MMR) vaccine recommendations for international travelers
Updated recommendations for meningococcal ACWY conjugate and B vaccines, including the addition of MenABCWY and removal of MenACWY-D
Added table summarizing possible immunizations for children and adolescents with HIV
Expanded discussion on postvaccination serology and revaccination
Added information regarding human papillomavirus vaccination
Updated recommendations on rotavirus vaccination in infants
Added bedaquiline, imipanem/cilastatin, and isavuconazole
Removed interferon-alfa-2b, pegylated interferon alfa-2a, and pegylated interferon alfa-2b
Added bedaquiline, isavuconazole, and ketoconazole
Removed boceprevir, capreomycin, interferon-alfa, paromomycin, and telaprevir
All updates are developed by the subject matter groups listed in Appendix C of the guidelines and reviewed by editors and relevant outside reviewers before finalization.
For a list of recent updates, please see What's New in the Guidelines. To view or download the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV, go to the Clinicalinfo website. The guidelines tables and recommendations also can be downloaded as separate PDF files.
Clinicalinfo welcomes your feedback on the latest revisions to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV. Please send your comments with the subject line “Pediatric Opportunistic Infections Guidelines” to HIVinfo@NIH.gov by June 19, 2025.