WHO optimal antiretroviral dosing guidance: recommendations for dosing medicines for HIV prevention and treatment in paediatric populations

Optimizing antiretroviral therapy for children living with or exposed to HIV remains a critical global health priority, particularly in settings where variability in formulations and limited resources complicate safe and effective dosing. This guidance presents updated recommendations on antiretroviral drug dosing for neonates, infants and children, drawing on recent pharmacokinetic evidence, clinical studies and expert consensus to support HIV prevention and treatment in paediatric populations.

The document outlines harmonized weight-band dosing approaches intended to simplify prescribing, dispensing and programme implementation while maintaining appropriate drug exposure across age groups. It describes key updates to neonatal and paediatric dosing, including revised regimens for commonly used medicines such as dolutegravir and abacavir/lamivudine, and provides detailed dosing tables for a range of formulations. Additional sections address considerations for preterm infants, differences between prophylaxis and treatment, and dose adjustments in the context of tuberculosis co-treatment. Programme and regulatory aspects, as well as evidence gaps and priorities for future formulation development, are also highlighted to support clinicians, programme managers and policy-makers in delivering effective paediatric HIV care.