Clinical info: Update of the guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV

The Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV (Pediatric Opportunistic Infection Guidelines) document is published in an electronic format that can be updated easily as relevant changes in prevention and treatment recommendations occur.

The editors and subject-matter experts are committed to timely changes in this document because many health care providers, patients, and policy experts rely on this source for vital clinical information.

All changes are developed by the subject-matter groups listed in the document; changes in group composition also are posted promptly. These changes are reviewed by the editors and relevant outside reviewers before the document is altered. Major revisions within the last 6 months are as follows:

April 23, 2026

Mycobacterium avium Complex Disease
Added linezolid, moxifloxacin, and bedaquiline as options for alternative therapy in children with severe symptoms or disseminated disease who need an alternative to rifabutin or a fourth drug as part of their treatment regimen.
Varicella-Zoster Virus Disease
Added valacyclovir as preferred therapy in children aged ≥3 months with no or moderate immunosuppression diagnosed with uncomplicated herpes zoster or mild varicella.
Clarified indications for passive immunization with varicella-zoster immune globulin (available as VariZIG) or intravenous immunoglobulin (or IVIG) after exposure to herpes zoster or varicella.

Link to the document: What's New: Pediatric OIs HIV Clinical Guidelines | NIH