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Erschienen in:

01.12.2023 | Pediatric Infectious Disease (M Mitchell and F Zhu, Section Editors)

Updates in the Approach to Pediatric HIV Care and Prevention

verfasst von: Claudia Vicetti Miguel, MD, Sheryl L. Henderson, MD, PhD

Erschienen in: Current Treatment Options in Pediatrics | Ausgabe 4/2023

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Abstract

Purpose of review

Awareness of updates on the recommendations for the treatment and prevention of HIV in children and adolescents is of vital importance for pediatricians to support HIV elimination efforts in the USA.

Recent findings

Children with HIV infection have access to potent antiretroviral regimens in combined and easier to administer formulations. For youth with HIV, simpler and long-acting treatment regimens are available. For infants born to persons with HIV that have low risk of perinatal transmission, an abbreviated regimen is recommended. Breastfeeding is supported for individuals on HIV treatment who remain virally suppressed. For adolescents and young adults at significant risk of HIV, pre-exposure prophylaxis is recommended.

Summary

Early treatment remains paramount for best outcomes in children and adolescents living with HIV, aided by innovative drugs and delivery methods. These advances should strive to equally benefit both the pediatric and adult populations. Despite progress, youth still comprise a significant portion of new HIV cases. Inclusive prevention strategies led by pediatricians are essential for HIV elimination in adolescents and young adults.
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Zurück zum Zitat •• Mayer KH, Molina JM, Thompson MA, et al. Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, non-inferiority trial. Lancet. 2020;396(10246):239–54. 5857 cisgender men who have sex with me or transgender women who have sex with men were randomyly assigned to receive either daily FTC/TDF or FTC/TAF for PrEFTC/TAF was shown to be non-inferior that FTC/TDF for HIV prevention.PubMedPubMedCentralCrossRef •• Mayer KH, Molina JM, Thompson MA, et al. Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, non-inferiority trial. Lancet. 2020;396(10246):239–54. 5857 cisgender men who have sex with me or transgender women who have sex with men were randomyly assigned to receive either daily FTC/TDF or FTC/TAF for PrEFTC/TAF was shown to be non-inferior that FTC/TDF for HIV prevention.PubMedPubMedCentralCrossRef
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Zurück zum Zitat •• Landovitz RJ, Donnell D, Clement ME, et al. Cabotegravir for HIV prevention in cisgender men and transgender women. N Engl J Med. 2021;385(7):595–608. 4566 cisgender men who have sex with men and transgender women who have sex with men and who were at-risk for HIV were randomized to receive either TDF/FTC or LA injectable CAB for PrEThe trial was stopped early for efficacy during the first interim end-point analysis that showed 3 times as many incident HIV infections in the TDF/FTC arm. LA CAB was superior to TDF/FTC in preventing HIV.PubMedPubMedCentralCrossRef •• Landovitz RJ, Donnell D, Clement ME, et al. Cabotegravir for HIV prevention in cisgender men and transgender women. N Engl J Med. 2021;385(7):595–608. 4566 cisgender men who have sex with men and transgender women who have sex with men and who were at-risk for HIV were randomized to receive either TDF/FTC or LA injectable CAB for PrEThe trial was stopped early for efficacy during the first interim end-point analysis that showed 3 times as many incident HIV infections in the TDF/FTC arm. LA CAB was superior to TDF/FTC in preventing HIV.PubMedPubMedCentralCrossRef
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Zurück zum Zitat •• Delany-Moretlwe S, Hughes J, Bock P, et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. Lancet. 2022;399(10337):1779–89. This phase 3 clinical trial enrolled 3224 individuals assigned female at birth at risk of HIV, who were randomly assigned to receive either TDF/FTC or LA CAB for PrEIncident HIV infection was 9 times higher in the TDF/FTC group, demonstrating superiority of LA CAB in preventing HIV infection in women.PubMedPubMedCentralCrossRef •• Delany-Moretlwe S, Hughes J, Bock P, et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. Lancet. 2022;399(10337):1779–89. This phase 3 clinical trial enrolled 3224 individuals assigned female at birth at risk of HIV, who were randomly assigned to receive either TDF/FTC or LA CAB for PrEIncident HIV infection was 9 times higher in the TDF/FTC group, demonstrating superiority of LA CAB in preventing HIV infection in women.PubMedPubMedCentralCrossRef
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Zurück zum Zitat Landovitz RJ, Li S, Eron JJ Jr, et al. Tail-phase safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir in HIV-uninfected adults: a secondary analysis of the HPTN 077 trial. Lancet HIV. 2020;7(7):e472–81.PubMedPubMedCentralCrossRef Landovitz RJ, Li S, Eron JJ Jr, et al. Tail-phase safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir in HIV-uninfected adults: a secondary analysis of the HPTN 077 trial. Lancet HIV. 2020;7(7):e472–81.PubMedPubMedCentralCrossRef
Metadaten
Titel
Updates in the Approach to Pediatric HIV Care and Prevention
verfasst von
Claudia Vicetti Miguel, MD
Sheryl L. Henderson, MD, PhD
Publikationsdatum
01.12.2023
Verlag
Springer International Publishing
Erschienen in
Current Treatment Options in Pediatrics / Ausgabe 4/2023
Elektronische ISSN: 2198-6088
DOI
https://doi.org/10.1007/s40746-023-00278-x

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