Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

Actualizado
Reviewed
Ene. 24, 2022

The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children document is published in an electronic format that can be updated easily as relevant changes in prevention and treatment recommendations occur.

The editors and subject-matter experts are committed to timely changes in this document because so many health care providers, patients, and policy experts rely on this source for vital clinical information.

All changes are developed by the subject-matter groups listed in the document (changes in group composition also are posted promptly). These changes are reviewed by the editors and by relevant outside reviewers before the document is altered.

What’s New

January 24, 2022

Nominations for New Members to Join the HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

The HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (or the Panel) is accepting nominations for new scientific/clinical members with expertise in pediatric HIV infection and infectious diseases to join the Panel.

Panel members critically evaluate new information and make revisions to the guidelines with assistance from the Panel’s coordinator and editorial support staff, and under the guidance of the Leadership and Executive Secretary. The candidates shall be recognized experts in pediatric HIV and opportunistic infectious diseases. Special interests in the following areas are desirable but not required:

  • Candida infections
  • Herpes Viruses
  • Immunizations
  • Invasive bacterial infections
  • Parasitology
  • Travel medicine

The selected candidates shall serve a four-year term beginning April 2022, with potential for reappointment. Because these guidelines are focused on management of HIV-exposed and HIV-infected children within the United States, candidates should be from the United States.

The Panel is a Working Group of the Office of AIDS Research Advisory Council (OARAC) of the National Institutes of Health (NIH). The Panel is comprised of approximately 30 members who are clinicians, researchers, academicians, and HHS representatives with expertise in management of opportunistic infections and illnesses in HIV-exposed and HIV-infected children, pre-adolescents and adolescents.

The Panel meets biannually via teleconferencing to review and critically evaluate emerging scientific data relating to approvals of new drugs, vaccines, medical devices, or diagnostics; new information regarding indications or dosing; new safety or efficacy data; or other information that may affect prevention and treatment of HIV-related opportunistic infections in children and to revise the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children.

Panel members are not financially compensated for their time commitment.

The nomination should include a curriculum vitae or resume, and a letter of nomination or letter of interest with specific reference to how the nominee would contribute to the work of the Panel. Please submit all supporting documents to Adam Malleck, Clinical info Guidelines Coordinator, at adam.malleck@nih.gov. Nominations will be accepted until Monday, February 28, 2022.

January 4, 2022

Nominations for Members to Join the Leadership of the HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

The HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (or the Panel) is accepting nominations for scientific/clinical members with expertise in pediatric HIV infection and infectious diseases to join the Leadership of the Panel.

Panel members critically evaluate new information and prepare guidelines revisions, and as members of the Leadership, work with assistance from the Executive Secretary to administer and direct Panel proceedings. The candidates shall be recognized experts in their areas of interest with a record of publications and presentations. The selected candidates shall serve a four-year term beginning March 2022, with potential for reappointment. Because these are guidelines focused on management of HIV-exposed and HIV-infected children within the United States, candidates should be from the United States.

The Panel is a Working Group of the Office of AIDS Research Advisory Council (OARAC) of the National Institutes of Health (NIH). The Panel is comprised of approximately 30 members who are clinicians, researchers, academicians, and HHS representatives with expertise in management of opportunistic infections and illnesses in HIV-exposed and HIV-infected children, pre-adolescents, and adolescents.

The Panel meets biannually via teleconferencing to review and critically evaluate emerging scientific data relating to approvals of new drugs, vaccines, medical devices, or diagnostics; new information regarding indications or dosing; new safety or efficacy data; or other information that may affect prevention and treatment of HIV-related opportunistic infections in children and to revise the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children.

Panel members are not financially compensated for their time commitment.

The nomination should include a curriculum vitae and a letter of nomination or letter of interest with specific reference to how the nominee would contribute to the work of the Panel. Please submit all supporting documents to Adam Malleck, Clinical Info Guidelines Coordinator, at adam.malleck@nih.gov. Nominations will be accepted until 1/31/22.

March 19, 2021

The Panel has begun to make revisions to bring the Guidelines up to date. Revisions are limited to a few sections at present, but this is an effort that will continue until all chapters are updated.

After the 2013 full guidelines release, the Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children (the Panel) modified its process so that individual sections would be published as they were updated, allowing for more timely appearance of new recommendations. Each section will be marked with the date of its last update and the summary of changes will be listed below. For a full description of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children, see the updated Summary.

Additionally, the evidence review and recommendation rating system underwent major changes; this new approach is incorporated into sections as they are individually updated. As a result, topics not yet updated since the 2013 release reflect the former rating system, and sections updated since 2013 use a newer, modified GRADE system. A description of the methods of collecting and synthesizing evidence and formulating and rating recommendations appears in the Background and Recommendations Rating Scheme section.


Major section revisions within the last 24 months are as follows:

December 9, 2019

Varicella-Zoster Virus: The Panel updated this section to include new information on VariZIG, which is now readily available for passive immunization when indicated. Additional evidence now supports protection by VariZIG when administered within 10 days of exposure to varicella-zoster virus (VZV). The section has also been updated to reflect the new recommendation rating system and references were added.

October 25, 2019

Vaccine-Preventable Diseases in Children and Adolescents with HIV Infection: The Panel updated this section and the recommended immunization schedule to include new vaccines available for the prevention of meningococcal infection (MenACWY-D [Menactra], MenACWY-CRM [Menveo], MenB-4C [Bexsero], and MenB-FHbp [Trumenba]) and HPV (9vHPV), and to include an expanded discussion of yellow fever vaccine (YFV) recommendations for children with HIV. The section has also been updated to reflect the new recommendation rating system and references were added.

The recommended immunizations schedule has been consolidated from two figures (ages 0-6 and 7-18 years) into a single schedule (Figure 1) spanning birth through age 18 years. Updates reflect 2019 Advisory Committee on Immunization Practices (ACIP) recommendations, which include specific recommendations for children with HIV.

August 29, 2019

Cryptosporidiosis: There are no major changes to the guidance for the diagnosis and management of cryptosporidiosis in children and adolescents living with HIV. Minor updates to the main text of the section include additional information on epidemiology, clinical manifestations and new diagnostic methodologies, along with updated references and links to additional resources on preventive measures. The section has been updated to reflect the new recommendation rating system.

August 22, 2019

Giardiasis: There are no major changes to the guidance for the diagnosis and management of giardiasis in children and adolescents living with HIV. Minor updates to the main text of the section include information on new diagnostic methodologies and additional details on the approach to diagnosis when giardiasis is suspected but stool testing is negative. The section has been updated to reflect the new recommendation rating system and references were added.

The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children document is published in an electronic format that can be updated easily as relevant changes in prevention and treatment recommendations occur.

The editors and subject-matter experts are committed to timely changes in this document because so many health care providers, patients, and policy experts rely on this source for vital clinical information.

All changes are developed by the subject-matter groups listed in the document (changes in group composition also are posted promptly). These changes are reviewed by the editors and by relevant outside reviewers before the document is altered.

What’s New

January 24, 2022

Nominations for New Members to Join the HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

The HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (or the Panel) is accepting nominations for new scientific/clinical members with expertise in pediatric HIV infection and infectious diseases to join the Panel.

Panel members critically evaluate new information and make revisions to the guidelines with assistance from the Panel’s coordinator and editorial support staff, and under the guidance of the Leadership and Executive Secretary. The candidates shall be recognized experts in pediatric HIV and opportunistic infectious diseases. Special interests in the following areas are desirable but not required:

  • Candida infections
  • Herpes Viruses
  • Immunizations
  • Invasive bacterial infections
  • Parasitology
  • Travel medicine

The selected candidates shall serve a four-year term beginning April 2022, with potential for reappointment. Because these guidelines are focused on management of HIV-exposed and HIV-infected children within the United States, candidates should be from the United States.

The Panel is a Working Group of the Office of AIDS Research Advisory Council (OARAC) of the National Institutes of Health (NIH). The Panel is comprised of approximately 30 members who are clinicians, researchers, academicians, and HHS representatives with expertise in management of opportunistic infections and illnesses in HIV-exposed and HIV-infected children, pre-adolescents and adolescents.

The Panel meets biannually via teleconferencing to review and critically evaluate emerging scientific data relating to approvals of new drugs, vaccines, medical devices, or diagnostics; new information regarding indications or dosing; new safety or efficacy data; or other information that may affect prevention and treatment of HIV-related opportunistic infections in children and to revise the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children.

Panel members are not financially compensated for their time commitment.

The nomination should include a curriculum vitae or resume, and a letter of nomination or letter of interest with specific reference to how the nominee would contribute to the work of the Panel. Please submit all supporting documents to Adam Malleck, Clinical info Guidelines Coordinator, at adam.malleck@nih.gov. Nominations will be accepted until Monday, February 28, 2022.

January 4, 2022

Nominations for Members to Join the Leadership of the HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

The HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (or the Panel) is accepting nominations for scientific/clinical members with expertise in pediatric HIV infection and infectious diseases to join the Leadership of the Panel.

Panel members critically evaluate new information and prepare guidelines revisions, and as members of the Leadership, work with assistance from the Executive Secretary to administer and direct Panel proceedings. The candidates shall be recognized experts in their areas of interest with a record of publications and presentations. The selected candidates shall serve a four-year term beginning March 2022, with potential for reappointment. Because these are guidelines focused on management of HIV-exposed and HIV-infected children within the United States, candidates should be from the United States.

The Panel is a Working Group of the Office of AIDS Research Advisory Council (OARAC) of the National Institutes of Health (NIH). The Panel is comprised of approximately 30 members who are clinicians, researchers, academicians, and HHS representatives with expertise in management of opportunistic infections and illnesses in HIV-exposed and HIV-infected children, pre-adolescents, and adolescents.

The Panel meets biannually via teleconferencing to review and critically evaluate emerging scientific data relating to approvals of new drugs, vaccines, medical devices, or diagnostics; new information regarding indications or dosing; new safety or efficacy data; or other information that may affect prevention and treatment of HIV-related opportunistic infections in children and to revise the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children.

Panel members are not financially compensated for their time commitment.

The nomination should include a curriculum vitae and a letter of nomination or letter of interest with specific reference to how the nominee would contribute to the work of the Panel. Please submit all supporting documents to Adam Malleck, Clinical Info Guidelines Coordinator, at adam.malleck@nih.gov. Nominations will be accepted until 1/31/22.

March 19, 2021

The Panel has begun to make revisions to bring the Guidelines up to date. Revisions are limited to a few sections at present, but this is an effort that will continue until all chapters are updated.

After the 2013 full guidelines release, the Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children (the Panel) modified its process so that individual sections would be published as they were updated, allowing for more timely appearance of new recommendations. Each section will be marked with the date of its last update and the summary of changes will be listed below. For a full description of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children, see the updated Summary.

Additionally, the evidence review and recommendation rating system underwent major changes; this new approach is incorporated into sections as they are individually updated. As a result, topics not yet updated since the 2013 release reflect the former rating system, and sections updated since 2013 use a newer, modified GRADE system. A description of the methods of collecting and synthesizing evidence and formulating and rating recommendations appears in the Background and Recommendations Rating Scheme section.


Major section revisions within the last 24 months are as follows:

December 9, 2019

Varicella-Zoster Virus: The Panel updated this section to include new information on VariZIG, which is now readily available for passive immunization when indicated. Additional evidence now supports protection by VariZIG when administered within 10 days of exposure to varicella-zoster virus (VZV). The section has also been updated to reflect the new recommendation rating system and references were added.

October 25, 2019

Vaccine-Preventable Diseases in Children and Adolescents with HIV Infection: The Panel updated this section and the recommended immunization schedule to include new vaccines available for the prevention of meningococcal infection (MenACWY-D [Menactra], MenACWY-CRM [Menveo], MenB-4C [Bexsero], and MenB-FHbp [Trumenba]) and HPV (9vHPV), and to include an expanded discussion of yellow fever vaccine (YFV) recommendations for children with HIV. The section has also been updated to reflect the new recommendation rating system and references were added.

The recommended immunizations schedule has been consolidated from two figures (ages 0-6 and 7-18 years) into a single schedule (Figure 1) spanning birth through age 18 years. Updates reflect 2019 Advisory Committee on Immunization Practices (ACIP) recommendations, which include specific recommendations for children with HIV.

August 29, 2019

Cryptosporidiosis: There are no major changes to the guidance for the diagnosis and management of cryptosporidiosis in children and adolescents living with HIV. Minor updates to the main text of the section include additional information on epidemiology, clinical manifestations and new diagnostic methodologies, along with updated references and links to additional resources on preventive measures. The section has been updated to reflect the new recommendation rating system.

August 22, 2019

Giardiasis: There are no major changes to the guidance for the diagnosis and management of giardiasis in children and adolescents living with HIV. Minor updates to the main text of the section include information on new diagnostic methodologies and additional details on the approach to diagnosis when giardiasis is suspected but stool testing is negative. The section has been updated to reflect the new recommendation rating system and references were added.

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