Children

All minors presenting following a potential risk of HIV exposure should be immediately considered for PEP. In the case of sexual assault, evaluation and treatment should be managed by a multidisciplinary team that is experienced in addressing the medical, psychosocial, and legal issues of such an offence. Parents or legal guardians should be notified unless the adolescent is ≥15 years and deemed legally competent to request that their guardians are not notified. Children who are sexually assaulted should be assessed for the risk of acquiring other STIs and the possibility of pregnancy for girls post-menarche. Emergency contraception should always be offered. The clinician should discuss key issues about PEP with the family and child as soon as possible. When parental or legal guardian consent cannot be obtained to initiate PEP, treatment may be initiated, with consent strongly recommended to continue PEP beyond the first hours/days. If PEP is prescribed, ensure sufficient medication is supplied to complete a full 28-day course.

Recommended dosage*:

Weight 35kg or more
Preferred option: Tenofovir + Emtricitabine PLUS Raltegravir
Secondary options:
1) Zidovudine + Lamivudine PLUS Raltegravir;
2) Zidovudine + Lamivudine PLUS Lopinavir + Ritonavir
Formulations
Tenofovir disoproxil fumarate 300mg + Emtricitabine 200mg (ONE co-formulated tab once daily) Do not use in renal impairment
Raltegravir 400mg tablet (ONE tab BD)
Tab: Zidovudine 300mg + Lamivudine 150mg (ONE co-formulated tab BD)
Tab: Adult Lopinavir 200mg + Ritonavir 50mg (TWO co-formulated tabs BD) Note strength of tablet

 

Weight under 35kg

Preferred option: Zidovudine + Lamivudine PLUS Lopin
avir + Ritonavir
≥3 years Preferred option: Zidovudine + Lamivudine PLUS Raltegravir (if chewable available) Secondary option: Zidovudine + Lamivudine PLUS Lopinavir + Ritonavir
Formulations
Zidovudine Cap
100mg or 250mg (180mg/m2/dose BD)
OR
Liquid: 10mg/ml (Max: 250mg BD)
Lamivudine Tab:
100mg or 150mg (4mg/kg/dose BD)
OR
Liquid: 10mg/ml (Max: 150mg BD)
Liquid: Lopinavir 80mg/ml + Ritonavir 20mg/ml (Co-formulated 300mg/m2/dose BD)
(Max: 400mg BD Dose based on Lopinavir)
OR

Tab: Paediatric Lopinavir 100mg +
Ritonavir 25mg
Note strength of tablet
(Co-formulated)
Surface area (m2):

Weight banded dosing using 100/25mg tablets:
15–25kg: TWO tablets BD
25–35kg: THREE tablets BD
> 35kg: FOUR tablets BD
Raltegravir 25mg or 100mg CHEWABLE tablets
These tablets are NOT bioequivalent to the 400mg Raltegravir tablet
CHEWABLE tablet:
11–14kg 75mg BD
14–20kg 100mg BD
20–28kg 150mg BD
28–40kg 200mg BD
> 40kg 300mg BD
If >25kg and can swallow tablets: 400mg tablet BD

*Determined in consultation with ANZPID Guidelines for post-exposure prophylaxis (PEP) after non-occupational exposure to blood borne viruses in children (2016).

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