Management of Treatment Failure for Pediatric and Adolescent Patients

Overview

About This Toolkit

This toolkit was developed in response to an identified need by health care providers on the steps needed to identify and address potential treatment failure among children and adolescents living with HIV. It aims to complement existing national and global guidelines on viral load monitoring and treatment experienced HIV and to serve as an easily accessible reference within health care facilities. This toolkit was updated in 2022 to reflect the current WHO guidelines1 for treatment management among people living with HIV.

Purpose of This Toolkit

The objective of this toolkit is to provide general guidance on determining treatment approaches for pediatric and adolescent patients with a high HIV viral load (VL). It contains tools for use in clinical practice by health care workers to support achieving viral load suppression or switching to a new or optimal treatment regimen.

Target Audience: Who Should Use This Toolkit?

This toolkit is primarily for health care providers, lay counselors, and multidisciplinary teams working with children and adolescents living with HIV.

How to Use This Toolkit

The toolkit is divided into three sections:

1. Management of treatment failure algorithm
2. HIV treatment failure clinical review form
3. Adherence counseling assessment and interventions checklist

This document was developed by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), with funding support from Johnson & Johnson, in support of the New Horizons Advancing Pediatric Human Immunodeficiency Virus (HIV) Care Collaborative. The New Horizons Collaborative is a multi-sectoral, coordinated effort aimed at improving and scaling pediatric and adolescent HIV and AIDS care and treatment through increased awareness, research, health systems strengthening, and access to antiretroviral medicines. The main objectives of the collaborative are 1) to address an immediate humanitarian need for advanced HIV antiretroviral therapy (ART) for children and adolescents and 2) to support health systems strengthening for national HIV and AIDS programs.