Maintaining infants and children on highly active antiretroviral therapy

ABSTRACT

It needs to be emphasized that human immuno-deficiency virus (HIV) infection is not a curable disease and therefore highly active antiretroviral therapy (HAART) requires a life long commitment. This is why it is of paramount importance to ensure adequate preparation before HAART is initiated and to continue supporting the child and the caregiver/family throughout. Strict and non-wavering adherence is more important in the treatment of HIV than in any other infectious or chronic disease. This is clearly demonstrated by the fact that at least 95adherence is required to ensure an optimal virologic response in the majority of children. (Table 1) Achieving an optimal virologic response (undetectable viral load) is vital; as the development of drug resistance is far more rapid if this is not attained. Due to the rapidity with which resistance may develop; treatment failure is always a concern and careful follow-up is required to ensure treatment