USE IN SPECIAL CIRCUMSTANCES FOR INITIAL THERAPY OF CHILDREN
Dual NRTI therapy alone is recommended for initial therapy only in Special Circumstances. Use of a regimen consisting of 2 NRTIs alone may be considered when the health care provider or guardian/patient has concerns regarding the feasibility of adherence to a more complex drug regimen. It is important to note that drug regimens that do not result in sustained viral suppression, such as a dual NRTI regimen, may result in the development of viral resistance to the drugs being used and cross-resistance to other drugs within the same drug class. Thus, a dual NRTI regimen would be chosen for initial therapy only under very limited circumstances.

š Dual NRTI combination recommendations: Strongly recommended choices: Zidovudine plus didanosine or lamivudine; or stavudine plus lamivudine. Alternative choices: Abacavir plus zidovudine or lamivudine; or didanosine plus lamivudine. Use in special circumstances: Stavudine plus didanosine; or zalcitabine plus zidovudine. Insufficient Data: Tenofovir- or emtricitabine-containing regimens. Not Recommended: Zalcitabine plus didanosine, stavudine, or lamivudine; or zidovudine plus stavudine