Long-term safety and effectiveness of ritonavir, nelfinavir, and lopinavir/ritonavir in antiretroviral-experienced HIV-infected children.

Details

Serval ID
serval:BIB_851BE6EEEA90
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-term safety and effectiveness of ritonavir, nelfinavir, and lopinavir/ritonavir in antiretroviral-experienced HIV-infected children.
Journal
Pediatric Infectious Disease Journal
Author(s)
Rudin C., Burri M., Shen Y., Rode R., Nadal D.
Working group(s)
Pediatric Infectious Disease Group of Switzerland, Swiss Mother, Child HIV Cohort Study (MoCHiV)
Contributor(s)
Aebi C., Bär W., Berger Ch., Besson F., Bühlmann U., Cheseaux JJ., Desgrandchamps D., Diana A., Duppenthaler A., Gervaix A., Gnehm HP., Heininger U., Hunzikerr UA., Kahlert C., Kind C., Kuchler H., Loher A., Masserey-Spicher V., Myers C., Nadal D., Posfay-Barbe C., Rudin C., Schaad UB., Siegrist CA., Stähelin J., Vaudaux B., Wyler-Lazarevic CA., Zingg W., Aebi C., Battegay M., Bernasconi E., Biederman K., Böni J., Bucher H., Bürgisser P., Cattacin S., Cavassini M., Cheseaux JJ., Drack G., Dubs R., Egger M., Elzi L., Erb P., Fantelli K., Fischer M., Flepp M., Fontana A., Francioli P., Furrer HJ., Gorgievski M., Günthard H., Gyr T., Hirschel B., Hösli I., Kaiser L., Kind C., Klimkait T., Lauper U., Leuenberger L., Ledergerber B., Martinez B., Nadal D., Opravil M., Paccaud F., Pantaleo G., Perrin L., Piffaretti JC., Rickenbach M., Rudin C., Schiffer V., Schreyer A., Schüpbach J., Speck R., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Wechsler A., Wunder D., Wyler CA., Yerly S.
ISSN
0891-3668 (Print)
ISSN-L
0891-3668
Publication state
Published
Issued date
05/2008
Peer-reviewed
Oui
Volume
27
Number
5
Pages
431-437
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
AIM: To evaluate the long-term safety and effectiveness of ritonavir, nelfinavir, and lopinavir/ritonavir in antiretroviral-experienced, initially protease inhibitor (PI)-naive, human immunodeficiency virus (HIV)-1-infected children.
METHODS: HIV-1-infected children enrolled in the Swiss Mother and Child HIV Cohort Study were eligible for this observational cohort study if they received at least 1 PI of interest between March 1996 and October 2003: ritonavir, nelfinavir, or lopinavir/ritonavir. Data regarding demographics, clinical disease and antiretroviral treatment history, HIV-1 RNA copies/mL, CD4 T-cell counts [absolute (cells/microL) and percentages (%)], adverse events, clinical laboratory values, reasons for discontinuation of PIs, and concomitant medications were extracted from the database for PI-naive (first-line) and PI-experienced (second- or higher-line) PI use.
RESULTS: The total duration of ritonavir, nelfinavir, and lopinavir/ritonavir use for 133 HIV-1-infected children was 163.8, 235.0, and 46.1 patient-years, respectively. In an on-treatment analysis, first-line therapy with any of the PIs significantly reduced HIV-1 concentrations and increased CD4 T-cell counts and percentages from baseline throughout the 288-week study (P <or= 0.05) for ritonavir and nelfinavir and throughout 84 weeks of use for lopinavir/ritonavir, which was introduced into treatment more recently. All PIs investigated were most effective in PI-naive children. Thirteen PI-associated toxicities occurred requiring treatment changes or interruptions (neurologic symptoms, n = 2; pancreatitis, n = 1; allergic reactions, n = 4; visual symptoms, n = 3; and hyperlipidemia, n = 3).
CONCLUSIONS: Long-term PI-based therapy seems to be safe and to result in durable virologic and immunologic effectiveness in HIV-1-infected antiretroviral-experienced children.
Keywords
Adolescent, CD4 Lymphocyte Count, Child, Child, Preschool, Cohort Studies, Female, HIV Infections/drug therapy, HIV Infections/immunology, HIV Protease Inhibitors/adverse effects, HIV Protease Inhibitors/therapeutic use, HIV-1, Humans, Infant, Infant, Newborn, Longitudinal Studies, Lopinavir, Male, Nelfinavir/adverse effects, Nelfinavir/therapeutic use, Pregnancy, Pyrimidinones/adverse effects, Pyrimidinones/therapeutic use, Ritonavir/adverse effects, Ritonavir/therapeutic use, Switzerland, Treatment Outcome, Viral Load, Withholding Treatment
Pubmed
Web of science
Create date
06/03/2009 10:32
Last modification date
20/08/2019 14:44
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