(ATDN) PCP prevention for children

(ATDN) PCP prevention for children

Treatment Review #18; April 1995

Researchers studied data from Florida, California and Massachusetts to see how many children less than a year old in the United States get pneumocystis carinii pneumonia (PCP). This type of pneumonia is common in children and adults who are HIV-positive. If left untreated, PCP causes death. But it is usually both preventable and treatable.

The study shows that as many as two-thirds of infants exposed to HIV were not tested for HIV. The number of infants getting PCP who were born to HIV-infected mothers changed little between 1989 and 1992. More than half of the babies who got PCP were never given preventive medication.

Although many infants born to HIV+ mothers will no longer be HIV+ themselves after six months when their own immune systems take over, it is important to follow the infant's bloodwork to see if preventive medication is needed.

A greater number of HIV-exposed infants must be identified at an earlier stage, and preventive medication should be prescribed, according to new guidelines that emphasize how the failure to identify HIV-exposed children has contributed to the increase of PCP in children. It is recommended that HIV testing and monitoring be made more available to children at risk. These guidelines recommend that all HIV-exposed infants begin preventive medication for PCP at four to six weeks, regardless of CD4 count and HIV test results. PCP prevention should be stopped once a child has been diagnosed as HIV-negative.

The drugs used for preventing PCP are the same for children as adults, though in different doses and in liquid formulations when given to infants too young to take pills. The drugs are Bactrim or Septra (two brands of the same drug), dapsone, pentamidine, and atovaquone, whose brand name is Mepron. First choice of treatment is Bactrim or Septra.

Two trials for testing PCP prevention drugs in children are currently enrolling. One is for dapsone in liquid form, either once a day or once a week. The other is testing the combination of atovaquone, azithromycin and Bactrim in pill form for children 2 years or older. Call The Network at (800) 734-7104 for more information.

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Always watch for outdated information. This article first appeard in 1995. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1995. AEGIS.