Bibliographic Info
Recommendation
Recommended in favor
Conditional
Certainty of evidence
Low
dolutegravir (DTG) in combination with an optimized nucleoside reverse-transcriptase inhibitor backbone is recommended as the preferred second-line regimen for children with approved DTG dosing for whom non-DTG-based regimens are failing
Notes and Remarks
In settings or populations in which DTG is not accessible or unsuitable because of toxicity and national levels of pretreatment HIV drug resistance are ≥10%, PI/r-based ARV drugs should be used in first-line ART. The choice of PI/r will depend on the programmatic characteristics. Alternatively, and if feasible, HIV drug resistance testing can be considered to guide the selection of first-line ART regimen (see Section 4.9 and Table 4.3). b As of July 2021, the United States Food and Drug Administration and the European Medicines Agency have approved DTG for infants and children older than four weeks and weighing at least 3 kg.
Also Featured In
This recommendation also appears in the following guidelines:
Consolidated guidelines on general HIV care and the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach