Bibliographic information
Recommendation
Children. Abacavir (ABC) + lamivudine (3TC) is recommended as the preferred backbone regimen for HIV post-exposure prophylaxis for children <30 kg. Zidovudine (AZT) + 3TC or tenofovir disoproxil fumarate (TDF) + 3TC or emtricitabine (FTC) can be considered as alternative regimens
Recommended in favor
Strong
Certainty of evidence
Low
Notes and Remarks
Considerations related to PEP regimens Currently recommended regimens for PEP are safe and have limited side-effects. Hepatitis B is not a contraindication for offering PEP regimens that include TDF, FTC or 3TC, and so assessing for and ruling out hepatitis B infection should not be a precondition for offering PEP. Hepatitis B virus tests are not available everywhere and particularly scarce in community settings. However, if the test is available and particularly in settings where hepatitis B is hyperendemic, people started on PEP should be tested for hepatitis B to detect active infection and the need for treatment. Results of hepatitis B testing have no relevance to PEP prescribing decisions. People with active HBV infection should be monitored for a flare of hepatitis after discontinuation of TDF-, 3TC- or FTCbased PEP if these drugs are not continued for the treatment of HBV. This may require referral to a hepatologist. Hepatitis flares are extremely rare. Choice of an HIV PEP regimen should consider the ARV drugs already being procured within national HIV programmes. Additional considerations include the availability of heatstable formulations, daily dosing, availability and affordability.
Also Featured In
This recommendation also appears in the following guidelines:
Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents and children: recommendations for a public health approach: December 2014 supplement to the 2013 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection
Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach