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Low-cost drug gaining favor for use in HIV-infected children in poor countries

05, the WHO gathered HIV/AIDS experts from around the world -- including Grimwade -- to pore over the scientific evidence on the preventive use of cotrimoxazole for people with HIV.

Nine months later, Grimwade said despite concerns over drawing conclusions from one study there is now much more consensus. She said, "the new WHO guidelines will likely recommend its use in both infected adults and children."

"In the latest discussions, there's no talk of further studies. It's basically accepted now," she added. The results from the single trial are so strong, Grimwade said, that many people believe that it is unethical to use a placebo in children to further investigate the preventive use of the drug.

Dr. Marco Antônio de Ávila Vitória, a medical officer with the WHO's Department of HIV/AIDS, also said preventive use of cotrimoxazole is gaining wide acceptance.

"It's a very cheap strategy," he said, "and the drug is very available, a lot more available in many areas where antiretroviral drugs are not around."

Cotrimoxazole is not a substitute for antiretroviral treatment, but the antibiotic may be a good stopgap measure until comprehensive HIV/AIDS care is available, or a way to extend the time until a patient needs anti-retroviral drugs, Vitória said.

Vitória said many discussions at the WHO summit centered on which settings would best benefit from preventive cotrimoxazole treatment given their health care infrastructure and ability to monitor and respond to possible side effects.

The WHO updated recommendations -- scheduled to be released early this year -- will provide some guidance for countries as they make their own decisions, Vitória said.

The recommendations include guidelines on monitoring toxicity and when to begin cotrimoxazole treatment given the child's age, whether the patient has symptoms of HIV disease and the strength of the patient's immune system.


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Source:Center for the Advancement of Health


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