"Although the pathogenesis of human immunodeficiency virus (HIV) infection and the general virologic and immunologic principles underlying the use of antiretroviral therapy are similar for all HIV-infected persons, there are unique considerations needed for HIV-infected infants, children, and adolescents, including a) acquisition of infection through perinatal exposure for many infected children; b) in utero exposure to zidovudine (ZDV) and other antiretroviral medications in many perinatally infected children; c) differences in diagnostic evaluation in perinatal infection; d) differences in immunologic markers (e.g., CD4+ T-lymphocyte count) in young children; e) changes in pharmacokinetic parameters with age caused by the continuing development and maturation of organ systems involved in drug metabolism and clearance; f) differences in the clinical and virologic manifestations of perinatal HIV infection secondary to the occurrence of primary infection in growing, immunologically immature persons; and g) special considerations associated with adherence to treatment for children and adolescents. This report addresses the pediatric-specific issues associated with antiretroviral treatment and provides guidelines to health-care providers caring for infected infants, children, and adolescents.""April 17, 1998.""These guidelines were developed by the Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children convened by the National Pediatric and Family HIV Resource Center ... the Health Resources and Services Administration ... and the National Institutes of Health ... The Co-Chairs of the Working Group were James Oleske ... and Gwendolyn B. Scott ..."--P. ii."U.S. Government Printing Office: 1998-633-228/67064 Region IV."--P. [4] of cover.Includes bibliographical references (p. 28-31)
