Federal health guidelines on pediatric HIV delivered a big change this past January: They now recommend that all HIV-positive infants begin HIV meds as soon as they are diagnosed, regardless of their CD4 counts. The guidelines authors cite a large South African study showing that infants have better survival rates if they are on meds, and that HIV often progresses faster in children under 5 than in older children and adults. The authors include advice on ensuring that babies swallow every dose—quite a task, as any mom or dad can tell you. To help with adherence, the guidelines suggest home visits by health care providers and “choos[ing] the most palatable medicine possible—pharmacists may be able to add syrups or flavoring agents to increase palatability.” (Find the guidelines at aidsinfo.nih.gov, or from AIDSinfo, P.O. Box 6303, Rockville, MD 20849.)
