WHO updates pediatric antiretroviral dosing guidelines to expand HIV treatment for children

SWITZERLAND—The World Health Organization (WHO) has released updated guidance on dosing antiretroviral medicines for neonates, infants, and children, aiming to strengthen HIV prevention and treatment for some of the youngest and most vulnerable patients.

The recommendations draw on the latest pharmacokinetic evidence, clinical studies, and expert consensus.

They provide harmonized, weight-band-based dosing schedules designed to simplify prescribing and dispensing while ensuring that children receive appropriate drug exposure across different age groups.

Updated dosing for key HIV medicines

The guidance updates dosing recommendations for several widely used paediatric antiretroviral medicines, including dolutegravir and the combination of abacavir and lamivudine.

It also includes detailed dosing tables covering a range of formulations, helping health workers select appropriate doses according to a child’s age, weight and treatment needs.

By standardizing dosing across weight bands, WHO aims to make the delivery of HIV medicines more straightforward for health workers and health programmes.

The approach is intended to support consistent prescribing and improve the implementation of paediatric HIV prevention and treatment services across different levels of care.

The document also provides specific guidance for preterm infants, who may require different dosing considerations because of their age and developmental stage.

In addition, it distinguishes between medicines used for HIV prevention and those prescribed for treatment, helping health workers apply the appropriate dosing schedules in each situation.

Guidance for children receiving tuberculosis treatment

WHO also outlines dose adjustments for children receiving antiretroviral therapy alongside tuberculosis treatment.

Because some tuberculosis medicines can interact with antiretrovirals, health workers need clear recommendations to ensure children receive effective HIV treatment while managing tuberculosis.

The guidance further identifies gaps in the available evidence and highlights priorities for future research and the development of paediatric antiretroviral formulations.

These priorities are intended to support continued improvements in the availability of medicines that are suitable for children of different ages and developmental stages.

“Every child living with or exposed to HIV deserves access to medicines that are safe, effective and simple to use,” said Dr Tereza Kasaeva, Director of the WHO Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections.

“This guidance closes a long-standing gap and equips health workers with clear, harmonized dosing recommendations that reflect the latest scientific evidence, helping countries deliver high-quality, person-centred HIV care from birth through adolescence,” she added.

Supporting paediatric HIV care

The guidance is intended as a practical resource for clinicians, programme managers and policy-makers responsible for delivering age-appropriate HIV prevention and treatment services.

It is designed to support health systems in translating the latest scientific evidence into practical dosing approaches for children.

WHO is working with countries and partners to scale up implementation of the updated recommendations and improve access to appropriate antiretroviral formulations for children.

Through its normative leadership and technical support, the organization aims to help countries expand equitable access to effective HIV prevention and treatment services for children and accelerate efforts to end AIDS as a public health threat.