Children

Atazanavir boosted by ritonavir combined with two nucleoside reverse transcriptase inhibitor (NRTIs) is a preferred first-line treatment regimen for children aged 6-18 years in US and European (PENTA) treatment guidelines.

Atazanavir dosing in children up to age 18 is based upon body weight, but should never exceed the adult recommended dose. Atazanavir with ritonavir-boosting can be used in all children 6 to 18 years, regardless of antiretroviral experience.

Atazanavir should always be taken with food. Weight-based dosing can be found at the Bristol-Myers Squibb website: http://packageinserts.bms.com/pi/pi_reyataz.pdf or at the website of the National Institutes of Health (NIH): http://aidsinfo.nih.gov.

In the US, if a treatment-naive individual aged 13 years and older and weighing at least 39kgs cannot tolerate ritonavir, the recommended dose is atazanavir 400mg once daily with food.

The use of atazanavir is not recommended in children younger than 6 years; without ritonavir in children from 6 to 12 years, or for any child whose weight is less than 25kgs.

Atazanavir cannot be used in infants because of the risk of kernicterus, a type of brain damage caused by excess levels of bilirubin. 

The safety profile of atazanavir in children is similar to adults. The most commonly observed moderate to severe side-effects are cough (21%), fever (19%), jaundice (13%), diarrhoea (8%), vomiting (8%), headache (7%), and runny nose (6%). Increased levels of bilirubin were found in the blood of 49% of individuals. In the P1020A study, 8.5% of individuals had a bilirubin level more than five times the upper limit of normal.1

References

  1. Rutstein R et al. Effect of atazanavir on serum cholesterol and triglyceride levels in HIV-infected infants, children and adolescents: PACTG 1020A. 12th Conference on Retroviruses and Opportunistic Infections, Boston, abstract 774, 2005
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

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We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.