Nelson Textbook of Pediatrics 22nd Edition | Combination antiretroviral therapy (cART) is the standard of care for all children with HIV, regardless of CD4 count or viral load. Goals: undetectable viral load, immune reconstitution, prevention of OIs, and reduced transmission. Regimens include 2 NRTIs + 1 INSTI (dolutegravir, raltegravir) or PI/r. Adherence is critical. Opportunistic infections require specific therapy. Post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) are available for at-risk individuals.
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