Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

PENTA 2009 guidelines for the use of antiretroviral therapy in paediatric HIV-1 infection

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Establishing a hepatitis C continuum of care among HIV/hepatitis C virus-coinfected individuals in EuroSIDA

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. HIV infection is independently associated with a higher concentration of alpha-1 antitrypsin

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The extent of B-cell activation and dysfunction preceding lymphoma development in HIV-positive people

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Genetical analysis of all Danish patients diagnosed with chronic granulomatous disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prevention of mother-to-child transmission of HIV in Denmark, 1994-2008

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Mode of delivery in HIV-infected pregnant women and prevention of mother-to-child transmission: changing practices in Western Europe

    Research output: Contribution to journalJournal articleResearchpeer-review

  • NN NN
  • Steve Welch
  • Mike Sharland
  • E G Hermione Lyall
  • Gareth Tudor-Williams
  • Tim Niehues
  • Uwe Wintergerst
  • Torsak Bunupuradah
  • Marc Hainaut
  • Marinella Della Negra
  • Maria José Mellado Pena
  • José Tomas Ramos Amador
  • Guido Castelli Gattinara
  • Alexandra Compagnucci
  • Albert Faye
  • Carlo Giaquinto
  • Diana M Gibb
  • Kate Gandhi
  • Silvia Forcat
  • Karen Buckberry
  • Lynda Harper
  • Christoph Königs
  • Deepak Patel
  • Diane Bastiaans
  • Niels Henrik Valerius
View graph of relations
PENTA Guidelines aim to provide practical recommendations for treating children with HIV infection in Europe. Changes to guidance since 2004 have been informed by new evidence and by expectations of better outcomes following the ongoing success of antiretroviral therapy (ART). Participation in PENTA trials of simplifying treatment is encouraged. The main changes are in the following sections: 'When to start ART': Treatment is recommended for all infants, and at higher CD4 cell counts and percentages in older children, in line with changes to adult guidelines. The number of age bands has been reduced to simplify and harmonize with other paediatric guidelines. Greater emphasis is placed on CD4 cell count in children over 5 years, and guidance is provided where CD4% and CD4 criteria differ. 'What to start with': A three-drug regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) with either a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (PI) remains the first choice combination. Lamivudine and abacavir are the NRTI backbone of choice for most children, based on long-term follow-up in the PENTA 5 trial. Stavudine is no longer recommended. Whether to start with an NNRTI or PI remains unclear, but PENPACT 1 trial results in 2009 may help to inform this. All PIs should be ritonavir boosted. Recommendations on use of resistance testing, therapeutic drug monitoring and HLA testing draw from data in adults and from European paediatric cohort studies. Recently updated US and WHO paediatric guidelines provide more detailed review of the evidence base. Differences between guidelines are highlighted and explained.
Original languageEnglish
JournalHIV Medicine
Volume10
Issue number10
Pages (from-to)591-613
Number of pages22
ISSN1464-2662
DOIs
Publication statusPublished - 2009

ID: 32524717