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Vol. 60. Núm. 3.
Páginas 262-268 (Marzo 2004)
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Vol. 60. Núm. 3.
Páginas 262-268 (Marzo 2004)
Acceso a texto completo
Recomendaciones para el tratamiento antirretroviral de inicio de la infección por el VIH en niños. Actualización 2003
Recommendations for initial antiretroviral treatment in HIV-infected children. update 2003
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...
M.aJ. Mellado Peña
Autor para correspondencia
mmellado.hciii@salud.madrid.org

Correspondencia: Hospital Carlos III. Servicio de Pediatría. Sinesio Delgado, 12. 28029 Madrid. España.
, Colaborativo Español para la Infección por el VIH en Pediatría (CEVIHP) , Grupo de trabajo de VIH de la Sociedad de Infectología Pediátrica (SEIP)
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Bibliografía
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Con el tratamiento antirretroviral de gran actividad (TARGA), la progresión a sida y las muertes relacionadas con la infección por el virus de la inmunodeficiencia humana (VIH) en niños han disminuido drásticamente y en la actualidad los niños tienen una excelente calidad de vida.

Los fármacos antirretrovirales no son capaces de erradicar de forma definitiva la infección, aunque sí mantenerla en situación latente. Sin embargo, su uso continuado tiene efectos secundarios, los más importantes las alteraciones metabólicas.

El gran número de fármacos y las distintas situaciones de los pacientes: edad, tolerancia a los medicamentos, adherencia, problemas sociales, hacen muy complejo unificar los criterios de tratamiento de inicio en estos niños. Se debe intentar un equilibrio entre no retrasar el inicio del tratamiento, para evitar el deterioro inmunológico y minimizar los efectos secundarios a largo plazo.

Las recomendaciones de tratamiento de este grupo son una adaptación para nuestro medio de las pautas internacionales, basadas en la revisión de la literatura médica y en la experiencia propia. Este grupo ya publicó recomendaciones de tratamiento de niños infectados por el VIH en años anteriores. El motivo de este documento es actualizarlas.

Palabras clave:
Infección por el VIH
Niños
Terapia antirretroviral de gran actividad
Tratamiento de inicio
Fármacos de elección
Fármacos alternativos

Highly active antiretroviral therapy in HIV-infected children has been associated with a dramatic decrease in progression to AIDS and HIV-related deaths, and infected children currently have an excellent quality of life. Antiretroviral drugs cannot eradicate the virus, although they can achieve a situation of latent infection. However, chronic use of these drugs has multiple adverse effects, the most important of which are metabolic complications.

The large number of drugs required and patient characteristics such as age, tolerance to drugs, adherence, and social problems make unifying the criteria for initial therapy in HIV-infected children difficult. A balance should be sought between not delaying the start of treatment, to avoid immunologic deterioration, and minimizing the long-term adverse effects of the therapy.

The present treatment recommendations are adapted from international guidelines and are based on a literature review and on our own experience. Our group previously published recommendations on the treatment of HIV-infected children and the aim of the present article is to provide an update.

Key words:
HIV infection
Children
Highly active antiretroviral therapy
Initial therapy
Drugs of choice
Drugs options
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