The World Health Organization (WHO) released new guidance setting out updated recommendations for dosing antiretroviral medicines in neonates, infants and children to strengthen HIV prevention and treatment for the youngest patients. The recommendations draw on recent pharmacokinetic evidence, clinical studies and expert consensus.
The guidance provides harmonized, weight-band based dosing schedules intended to make prescribing and dispensing simpler for health workers, while keeping drug exposure appropriate across different age groups. It includes revised dosing for some of the most widely used paediatric HIV medicines, among them dolutegravir and the abacavir/lamivudine combination, along with detailed dosing tables covering a range of drug formulations.
The document also addresses dosing considerations specific to preterm infants, distinguishes between regimens used for prevention versus treatment, and outlines dose adjustments needed when a child is also being treated for tuberculosis.
"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, WHO Department for HIV, Tuberculosis, Hepatitis and STIs. "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."
The guidance:
- sets out harmonized weight-band dosing approaches meant to simplify prescribing, dispensing and programme implementation, while maintaining appropriate drug exposure across age groups;
- updates neonatal and paediatric dosing recommendations for key medicines, including revised regimens for dolutegravir and abacavir/lamivudine;
- provides detailed dosing tables spanning a range of paediatric drug formulations for use across different levels of care;
- covers special considerations for preterm infants and clarifies differences between prophylactic and treatment dosing;
- outlines dose adjustments required for children receiving concurrent tuberculosis treatment; and
- highlights remaining evidence gaps and priorities to guide future development of paediatric antiretroviral formulations.
The document is intended as a practical resource for clinicians, programme managers and policy-makers working to deliver effective, age-appropriate HIV prevention and treatment services for children.
WHO is working with countries and partners to scale up implementation of this updated dosing guidance, strengthen access to appropriate antiretroviral formulations for children, and accelerate progress towards ending AIDS among children as a public health threat. Through its normative leadership and technical support, WHO remains committed to helping countries translate guidance into action and expand equitable access to optimal HIV prevention and treatment services for every child.
