Treatment Guidelines

The United States Department of Health and Human Services provides clinical guidelines for the treatment of HIV/AIDS that are reviewed and updated by experts in the field. They are available at AIDSinfo. Included below are links to useful sections of the perinatal and pediatric guidelines as well as other resources for additional treatment information.

Sources of Treatment Information Include:

Preconceptional Care

• Preconceptional Counseling and Care for HIV-Infected Women of Childbearing Age ¹

Antepartum Care

• General Principles Regarding Use of Antiretroviral Drugs During Pregnancy ¹
• Recommendations for Use of Antiretroviral Drugs During Pregnancy ¹
• Special Situations (Hepatitis B co-infection, Hepatitis C co-infection, stopping ARV therapy, failure of viral suppression) ¹
• Monitoring of the Woman and Fetus During Pregnancy ¹
• Special Considerations (pharmacokinetics, maternal toxicity, teratogenicity) ¹
• Antiretroviral Drug Resistance and Resistance Testing in Pregnancy ¹
• Guidelines for Use of HIV Antiretroviral Therapy in Pregnancy ⁴

Intrapartum/Delivery Guidelines

• Intrapartum Antiretroviral Therapy/Prophylaxis (IV AZT guidelines, role of 3TC and Nevirapine, intrapartum maternal and neonatal dosing tables, suboptimal viral suppression, positive rapid tests) ¹
• Mode of Delivery ¹ 
• Other Intrapartum Management Considerations (artificial rupture of membranes, internal monitoring, operative delivery, postpartum hemorrhage) ¹
• IL Perinatal HIV Hotline Best Practices
• Guidelines for Use of HIV Antiretroviral Therapy in Pregnancy ⁴

Postpartum Care

• Postpartum Management (continuation of antiretrovirals, breastfeeding and risk of transmission, contraceptive counseling) ¹
• IL Perinatal HIV Hotline Best Practices
• Lactation Suppression (patient handout) ³
• Neonatal AZT Instructions (patient handout) ³
• Guidelines for Use of HIV Antiretroviral Therapy in Pregnancy ⁴

Neonatal Care

• Identification of Perinatal HIV Exposure ²
• Infants Born to Mothers with Unknown HIV Infection Status ¹
• Infant Antiretroviral Prophylaxis (AZT dosing including preterm infants, use of Nevirapine and 3TC) ¹
• IL Perinatal HIV Hotline Best Practices
• IL Perinatal HIV Hotline Neonatal Treatment Guidelines (AZT dosing, use of Nevirapine/3TC, PCP prophylaxis, HIV screening of exposed infants)
• Initial Postnatal Management of the HIV-Exposed Neonate ¹
• Long-Term Follow-Up of Antiretroviral Drug-Exposed Infants ¹
• Diagnosis of HIV Infection in Infants (choice of diagnostic test, timing of test, antibody testing) ²
• Laboratory Monitoring of Pediatric HIV Infection ²
• Treatment Recommendations for Pediatric HIV Infection ²
• Monitoring of Children on Antiretroviral Therapy ²
• Characteristics of Available Antiretroviral Drugs (dosing, toxicities, drug interactions, special instructions) ²
• Guidelines for Use of HIV Antiretroviral Therapy in Pregnancy ⁴

Research

• Clinical Research Needs (drug safety, drug resistance, stopping antiretroviral therapy, premature rupture of membranes, rapid testing) ¹

Other

• Women, Children, and HIV. Perinatal Interventions: Clinical Guidelines