Frequent dose adjustment for weight gain is advisable. Adrenal dysfunction reported in newborns. Monitor electrolytes. Avoid in premature

babies [305]. FDA recommendation (August 2011): the use of Kaletra oral solution should be avoided in premature babies until 14 days after their due date, or in full-term babies younger than 14 days of age unless a healthcare professional believes that the benefit of using Kaletra oral solution to treat HIV infection immediately after birth outweighs the potential risks. In such cases, FDA strongly recommends monitoring for increases in serum osmolality, serum creatinine, and other signs of toxicity. 900 mg/m2 once daily Mon/Wed/Fri < 6 months: 120 mg once daily Mon/Wed/Fri 6–12 months: check details 240 mg once daily Mon/Wed/Fri 8.1.1 Zidovudine monotherapy is recommended if maternal viral load is < 50 HIV RNA copies/mL at 36 weeks' gestation or thereafter prior to delivery (or mother delivered Selleck RAD001 by PLCS whilst on zidovudine monotherapy). Grading: 1C For women with fully suppressed HIV and a history of zidovudine resistance see discussion below. Zidovudine monotherapy for the infant has been part of the PMTCT

strategy since the publication of the results of ACTG 076 [62]. The relative contributions of the antenatal, peripartum and infant components have been difficult to quantify. In ACTG 076 neonatal zidovudine 2 mg/kg every 4 hours (five doses) was given for 6 weeks. Monotherapy for the infant is appropriate when there is a very low risk of HIV transmission. This occurs when a mother on combination therapy delivers with a viral load of < 50 HIV RNA copies/mL. The neonate should receive single-drug therapy for 4 weeks; this is practically easier Aprepitant for the family and reduces the risk of adverse events. With many years of experience, twice-daily zidovudine monotherapy is the neonatal treatment of choice, whatever the maternal ART combination. For infants born to mothers on fully suppressive ART, zidovudine monotherapy post-exposure prophylaxis remains

reasonable even where the mother has a previous history of zidovudine exposure with resistance (thymidine-associated mutations). On cART, the risk of transmission in the mother with fully suppressed viral replication is extremely low (∼ 0.1%), and although history of zidovudine resistance in maternal virus and infant post-exposure prophylactic regimen has not been dissected, the frequency of transmission of zidovudine-resistant virus is concomitantly very low. Data from the era when only maternal zidovudine monotherapy was available indicate preferential transmission of wild-type over zidovudine-resistant virus when a mixed population of virions are present [276]. In the Swiss cohort, none of six infants born to mothers harbouring zidovudine-resistant HIV (based on codon 215 analysis only) became infected [139].