Guidance on Paediatric ARV dosages

[Guest guest]

Dear Friends

With the initiative of NACO free ARV medicines are being provided to HIV

positive children from selected government ART centers.

It has been observed that some of these centers are providing combination drugs

in schedules not consistent with text book recommendations.

For example some children are asked to take one fixed dose tablet containing 30

mg of d4T in the morning and ½ in the evening. Does NACO recommend this

officially?

If so, let us know the scientific rationale so that others can follow it

confidently. It is also observed that children with body weight above 26-27 kg.

are started on full adult dose of fixed dose combination containing 30 mg of

d4T. What is the cut off value?

This dose is good enough for adults of weight 60 kg. Should we wait till weight

increases above 30kg?

As is a well known fact there are many centers providing care to HIV positive

children outside government centers who would look forward to NACO for

guidelines.

When paediatric formulations were not available these centers have done away

with adult tablets broken into pieces appropriate for weight knowing that it was

not exactly rational. It was however also noted that it definitely had an impact

on the morbidity and mortality of the children.

Now that paediatric formulations are available the problem has eased out but

these formulations are extremely costly as compared to adult formulations.

Secondly it is neither possible nor acceptable to all guardians that all

children get ART only from government centers.

Those treating children with HIV need guidance.

Sincerely

ARWA D

e-mail: <arwasd@...>