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Growing Up with HIV: A Comprehensive Review of Treatment and Care in Low- and Middle-Income Countries

Brigid E O'Brien1,2, Elizabeth Maidl3,4, Jacob L Todd3,5

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. Brigid.o'brien@bcm.edu.

Current HIV/AIDS Reports
|November 7, 2025
PubMed

Insights

Children and adolescents living with HIV (CALHIV) face unique challenges in low- and middle-income countries, including limited treatment options and emerging drug resistance. New, child-friendly therapies are crucial to improve care and meet global targets.

Area of Science:

  • Pediatric infectious diseases
  • HIV/AIDS research
  • Global health

Background:

  • Despite progress, children and adolescents living with HIV (CALHIV) encounter significant barriers to comprehensive care.
  • Limited treatment options, psychosocial challenges, and caregiver dependence hinder effective management in low- and middle-income countries (LMIC).

Purpose of the Study:

  • To review the current state of care for CALHIV in LMIC.
  • To identify challenges and unmet needs in pediatric HIV treatment.
  • To highlight the importance of child-friendly treatment options and addressing HIV drug resistance.

Main Methods:

  • Review of current literature on pediatric HIV care.
  • Analysis of treatment guidelines and emerging resistance patterns.
  • Assessment of global targets and treatment gaps for CALHIV.

Main Results:

  • CALHIV are not meeting global UNAIDS targets compared to adults.
  • Pre-treatment and acquired HIV drug resistance are more prevalent in CALHIV.
  • Novel pediatric fixed-dose combinations (FDC) like abacavir/lamivudine/dolutegravir (ABC/3TC/DTG) show promise, but alternatives are needed.

Conclusions:

  • Increased availability of child and adolescent-friendly treatment options is essential for lifelong comprehensive care.
  • Expanded research and access to novel therapies are critical to close treatment gaps and combat emerging HIV drug resistance in CALHIV.
  • Addressing unique developmental needs and vulnerabilities is key to successful pediatric HIV management.
Abstract

Keywords:
Comprehensive HIV careDTGDolutegravirHIV drug resistanceLong-acting antiretroviralsPediatric and adolescent HIVPediatric and adolescent antiretroviral therapyResistance in children

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