Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-84b7d79bbc-l82ql Total loading time: 0 Render date: 2024-07-25T08:03:09.374Z Has data issue: false hasContentIssue false

22 - Initiating and changing antiretroviral therapy

from Part III - Antiretroviral therapy

Published online by Cambridge University Press:  03 February 2010

By
Lynne M. Mofenson  and
Leslie K. Serchuck
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Lynne M. Mofenson
Affiliation:
Chief, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH, Rockville, MD
Leslie K. Serchuck
Affiliation:
Medical Officer, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH Rockville, MD
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Cancer Institute, Bethesda, Maryland
Get access

Summary

Introduction

Guidelines for antiretroviral therapy in children must incorporate considerations unique to pediatric HIV infection. Such considerations include: age-related changes in drug pharmacokinetics; issues related to diagnosis of perinatal infection (early diagnosis permits therapy to be initiated during primary HIV infection); normal age-related changes in immunologic parameters; differences between children and adults in the natural history of HIV infection (i.e. differences in virologic parameters during primary infection, in the rapidity of disease progression, and in the frequency of central nervous system (CNS) and growth abnormalities); prior antiretroviral exposure of newly infected infants (in utero and neonatal exposure to drugs used for maternal treatment and transmission prophylaxis); and pediatric-specific adherence issues (i.e. availability and palatability of drug formulations; relationship of drug administration to food intake in young infants; dependence on caregiver for administration of drugs).

Prospective, randomized, controlled clinical trials offer the best evidence for formulation of guidelines. However, most antiretroviral drugs are approved for use in pediatric patients based on efficacy data from clinical trials in adults, with supporting pharmacokinetic and safety data from phase I/II trials in children; additionally, efficacy in most adult trials has been based on surrogate marker data, as opposed to clinical endpoints. Thus, guidelines for treatment of HIV-infected children often have to rely on data regarding virologic/immunologic response to drug regimens in adult clinical trials, taking into account the specific considerations in pediatric HIV infection delineated above, and with attention to data from pediatric populations when available.

Type
Chapter
Information
Textbook of Pediatric HIV Care , pp. 355 - 376
Publisher: Cambridge University Press
Print publication year: 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Centers for Disease Control and Prevention. Guidelines for the use of antiretroviral agents in pediatric Human Immunodeficiency Virus infection. MMWR 47 Relative Risk—4, (1998), 1–43 (updates available at http://AIDSInfo.nih.gov)
Centers for Disease Control and Prevention. Guidelines for the use of antiretroviral agents in Human Immunodeficiency Virus-infected adults and adolescents. MMWR 47 Relative Risk-5 (1998), 43–82 (updates available at http://AIDSInfo.nih.gov)
Sharland, M., Castelli, G., Ramos, J. T., Blanche, S. & Gibb, D. M. The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome guidelines for the use of antiretroviral therapy in paediatric Human Immunodeficiency Virus infection — 2001. Updates available at http://www.ctu.mrc.ac.uk/PENTA
Patella, F. J. Jr., Delaney, K. M., Moorman, A. C.. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. New Engl. J. Med. 338 (1998), 853–60Google Scholar
Gortmaker, S. L., Hughes, M., Cervia, J.. Effect of combination therapy including protease inhibitors on mortality among children and adolescents infected with Human Immunodeficiency Virus-1. New Engl. J. Med. 345 (2001), 1522–8CrossRefGoogle Scholar
Martino, M., Tovo, P. -A., Balducci, M.. Reduction in mortality with availability of antiretroviral therapy for children with perinatal Human Immunodeficiency Virus-1 infection. J. Am. Med. Assoc. 284 (2000), 190–7CrossRefGoogle Scholar
Hammer, S. M., Squires, K. E., Hughes, M. D.. Controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and Cluster of Differentiation4 cell counts of 200 per cubic millimeter or less. Acquired Immune Deficiency Syndrome Clinical Trials Group 320 Study Team. New Engl. J. Med. 337 (1997), 725–33CrossRefGoogle Scholar
Fischl, M. A., Richman, D. D., Grieco, M. H.. The efficacy of azidothymidine (Zidovudine (also known as Zidovudine (also Known as AZT))) in the treatment of patients with Acquired Immune Deficiency Syndrome & Acquired Immune Deficiency Syndrome-related complex. New Engl. J. Med. 317 (1987), 185–91CrossRefGoogle Scholar
Idemyor, V.Commentary: Continuing debate over Human Immunodeficiency Virus therapy initiation. Human Immunodeficiency Virus Clin. Trials 3 (2002), 173–6Google Scholar
Volberding, P. A., Lagakos, S. W., Koch, M. A.. Zidovudine in asymptomatic human immunodeficiency virus infection — a controlled trial in persons with fewer than 500 Cluster of Differentiation4-positive cells per cubic millimeter. New Engl. J. Med. 322 (1990), 941–9CrossRefGoogle Scholar
Concorde Coordinating Committee. Concorde: MRC/Agence Nationale de Recherches sur le SIDA randomized, double-blind controlled trial of immediate and deferred zidovudine in symptom-free Human Immunodeficiency Virus infection. Lancet 343 (1994), 871–81CrossRef
Pediatric European Network for Treatment of Acquired Immune Deficiency Syndrome (The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome). Five year follow-up of vertically Human Immunodeficiency Virus infected children in a randomised double blind controlled trial of immediate verus deferred zidovudine: the The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome 1 trial. Arch. Dis. Child. 84 (2001), 230–6CrossRef
Mannheimer, S., Friedland, G., Matts, J.. The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clin. Infect. Dis. 34 (2002), 1115–21CrossRefGoogle ScholarPubMed
Paterson, D., Swindells, S., Mohr, J.. Adherence to protease inhibitor therapy and outcomes in patients with Human Immunodeficiency Virus infection. Ann. Intern. Med. 133 (2000), 21–30CrossRefGoogle Scholar
Bartlett, J. A.Addressing the challenges of adherence. J. Acquir. Immune Defic. Syndr. 29 (2002), S2-S10CrossRefGoogle ScholarPubMed
Dyke, R. B., Lee, S., Johnson, G. M.. Reported adherence as a determinant of response to highly active antiretroviral therapy in children who have human immuno-deficiency virus infection. Pediatrics 109 4 (2002), URL: http://www.pediatrics.org/cgi/content/full/109/e61Google Scholar
Pontali, E., Feasi, M., Toscanini, F.. Adherence to combination antiretroviral treatment in children. Human Immunodeficiency Virus Clin. Trials 2 (2001), 466–73Google ScholarPubMed
McKinney, R. E., Johnson, G. M., Stanley, K.. A randomized study of combined zidovudine-lamivudine versus didanosine monotherapy in children with symptomatic therapy-naïve Human Immunodeficiency Virus-1 infection. J. Pediatr. 133 (1998), 500–8CrossRefGoogle Scholar
Englund, J., Baker, C., Raskino, C.. Zidovudine, didanosine or both as initial treatment for symptomatic Human Immunodeficiency Virus-infected children. New Engl. J. Med. 336 (1997), 1704–12CrossRefGoogle ScholarPubMed
Fischl, M. A., Richman, D. D., Hansen, N.. The safety and efficacy of zidovudine in the treatment of subjects with mildly symptomatic Human Immunodeficiency Virus infection: a double-blind, placebo-controlled trial. Ann. Intern. Med. 112 (1990), 727–37CrossRefGoogle ScholarPubMed
Volberding, P. A,Lagakos, S. W., Grimes, J. M.. The duration of zidovudine benefit in persons with asymptomatic Human Immunodeficiency Virus infection — prolonged evaluation of protocol 019 of the Acquired Immune Deficiency Syndrome Clinical Trials Group. J. Am. Med. Assoc. 272 (1994), 437–42CrossRefGoogle Scholar
Pizzo, P. A., Eddy, J., Falloon, J.. Effect of continuous intravenous infusion of zidovudine (Zidovudine (also known as Zidovudine (also Known as AZT))) in children with symptomatic Human Immunodeficiency Virus infection. New Engl. J. Med. 319 (1988), 889–96CrossRefGoogle Scholar
McKinney, R. E., Maha, M. A., Connor, E. M.. A multicenter trial of oral zidovudine in children with advanced human immunodeficiency virus disease. New Engl. J. Med. 324 (1991), 1018–25CrossRefGoogle ScholarPubMed
Butler, K. M., Husson, R. N., Balis, F. M.. Dideoxyinosine in children with symptomatic human immunodeficiency virus infection. New Engl. J. Med. 324 (1991), 137–44CrossRefGoogle ScholarPubMed
Lewis, L. L., Venzon, D., Church, J.. Lamivudine in children with human immunodeficiency virus infection: a phase I/II study. J. Infect. Dis. 174 (1996), 16–25CrossRefGoogle ScholarPubMed
Kline, M. W., Dunkle, L. M., Church, J. A.. A phase I/II evaluation of stavudine (Stavudine) in children with human immunodeficiency virus infection. Pediatrics 96 (1995), 247–52Google ScholarPubMed
Gray, L., Newell, M. L., Thorne, C.. Fluctuations in symptoms in human immunodeficiency virus-infected children: the first 10 years of life. Pediatrics, 108 (2001), 116–22Google ScholarPubMed
Human Immunodeficiency Virus Paediatric Prognostic Markers Collaborative Study Group. Short-term risk of disease progression in Human Immunodeficiency Virus-1-infected children receiving no antiretroviral therapy or zidovudine monotherapy: estimates according to Cluster of Differentiation4 percent, viral load, and age. Lancet 362 (2003), 1605–11CrossRef
Abrams, E. J., Wiener, J., Carter, R.. Maternal health factors and early pediatric antiretroviral therapy influence the rate of perinatal Human Immunodeficiency Virus-1 disease progression in children. Acquired Immune Deficiency Syndrome 17 (2003), 867–77Google ScholarPubMed
Luzuriaga, K., Bryson, Y., Krogstad, P.. Combination treatment with zidovudine, didanosine and nevirapine in infants with human immunodeficiency virus type 1 infection. New Engl. J. Med. 336 (1997), 1343–9CrossRefGoogle ScholarPubMed
Luzuriaga, K., McManus, M., Catalina, M.. Early therapy of vertical Human Immunodeficiency Virus-1 Infection: Control of viral replication and absence of persistent Human Immunodeficiency Virus-1 specific immune responses. J. Virol. 74 (2000), 6984–91CrossRefGoogle ScholarPubMed
Luzuriaga, K., McManus, M., Mofenson, L.. A trial of three antiretroviral regimens in Human Immunodeficiency Virus-1-infected children. N. Engl. J. Med. 350 (2004), 2471–80CrossRefGoogle Scholar
Hainault, M., Peltier, C. A., Gerard, M.. Effectiveness of antiretroviral therapy initiated before the age of 2 months in infants vertically infected with human immunodeficiency virus type 1. Eur. J. Pediatr. 159 (2000), 778–82CrossRefGoogle Scholar
Faye, A., Bertone, C., Teglas, J. P.. Early multitherapy including a protease inhibitor for human immunodeficiency virus type 1-infected infants. Pediatr. Infect. Dis. J. 21 (2002), 518–25CrossRefGoogle ScholarPubMed
Altfeld, M., Rosenberg, E. S., Shankarappa, R.. Cellular immune responses and viral diversity in individuals treated during acute and early Human Immunodeficiency Virus-1 infection. J. Exp. Med. 193 (2001), 169–80CrossRefGoogle Scholar
Markowitz, M., Vesanen, M., Tenner-Racz, K.. The effect of commencing combination antiretroviral therapy soon after human immunodeficiency virus type 1 infection on viral replication and antiviral immune responses. J. Infect. Dis. 179 (1999), 525–37CrossRefGoogle ScholarPubMed
Carr, A. & Cooper, D. A.Adverse effects of antiretroviral therapy. Lancet 356 (2000), 1423–30CrossRefGoogle ScholarPubMed
Melvin, A. J., Lennon, S., Mohan, K. M. & Purnell, J. Q.Metabolic abnormalities in Human Immunodeficiency Virus type 1-infected children treated and not treated with protease inhibitors. Acquired Immune Deficiency Syndrome Res. Hum. Retrovirus. 17 (2001), 1117–23Google Scholar
Arpadi, S. M., Cuff, P. A., Horlick, M., Wang, J. & Kotler, D. P.Lipodystrophy in Human Immunodeficiency Virus-infected children is associated with high viral load and low Cluster of Differentiation4+-lymphocyte count and Cluster of Differentiation4+-lymphocyte percentage at baseline and use of protease inhibitors and stavudine. J. Acquired Immune Deficiency Syndrome Hum. Retrovirol. 27 (2001), 30–4CrossRefGoogle Scholar
Mora, S., Sala, N., Bricalli, D., Zuin, G., Chiumello, G., & Vigano, A.Bone mineral loss through increased bone turnover in Human Immunodeficiency Virus-infected children treated with highly active antiretroviral therapy. Acquired Immune Deficiency Syndrome 15 (2001), 1823–9Google Scholar
Cossarizza, A., Pinti, M., Moretti, L.. Mitochondrial functionality and mitochondrial Deoxyribonucleic Acid content in lymphocytes of vertically infected human immunodeficiency virus-positive children with highly active antiretroviral therapy-related lipodystrophy. J. Infect. Dis. 185 (2002), 299–305CrossRefGoogle ScholarPubMed
Brambilla, P., Bricalli, D., Sala, N.. Highly active antiretroviral-treated Human Immunodeficiency Virus-infected children show fat distribution changes even in absence of lipodystrophy. Acquired Immune Deficiency Syndrome 15 (2001), 2415–22Google Scholar
Galli, L., Martino, M., Tovo, P. A.. Predictive value of the Human Immunodeficiency Virus paediatric classification system for the long-term course of perinatally infected children. Int. J. Epidemiol. 29 (2000), 573–8CrossRefGoogle ScholarPubMed
Mofenson, L. M., Korelitz, J., Meyer, W. A.. The relationship between serum human immunodeficiency virus type 1 (Human Immunodeficiency Virus-1) Ribonucleic Acid level, Cluster of Differentiation4 lymphocyte percent, and long-term mortality risk in Human Immunodeficiency Virus-1-infected children. J. Infect. Dis. 175 (1997), 1029–38CrossRefGoogle Scholar
Palumbo, P. E., Raskino, C., Fiscus, S.. Virologic and immunologic response to nucleoside reverse-transcriptase inhibitor therapy among human immunodeficiency virus-infected infants and children. J. Infect. Dis. 179 (1999), 576–83CrossRefGoogle ScholarPubMed
Palumbo, P. E., Raskino, C., Fiscus, S.. Predictive value of quantitative plasma Human Immunodeficiency Virus Ribonucleic Acid and Cluster of Differentiation4+ lymphocyte count in Human Immunodeficiency Virus-infected infants and children. J. Am. Med. Assoc. 279 (1998), 756–61CrossRefGoogle Scholar
Sharland, M., Gibb, D. & Giaquinto, C.on behalf of the The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome Steering Committee. Current evidence for the use of paediatric antiretroviral therapy — a The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome analysis. Eur. J. Pediatr. 159 (2000), 649–56CrossRefGoogle Scholar
Delta Coordinating Committee. Delta: a randomized, double-blind controlled trial comparing combinations of zidovudine plus didanosine or zalcitabine with zidovudine alone in Human Immunodeficiency Virus-infected individuals. Lancet 348 (1996), 283–91CrossRef
Hammer, S. M., Katzenstein, D. A., Hughes, M. D.. A trial comparing nucleoside monotherapy with combination therapy in Human Immunodeficiency Virus-infected adults with Cluster of Differentiation4 cell counts from 200 to 500 per cubic millimeter. New Engl. J. Med. 335 (1996), 1081–90CrossRefGoogle Scholar
Hammer, S. M., Squires, K. E., Hughes, M. D.. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and Cluster of Differentiation4 counts of 200 per cubic millimeter or less. New Engl. J. Med. 337 (1997), 725–33CrossRefGoogle ScholarPubMed
Collier, A. C., Coombs, R. W., Schoenfeld, D. A.. Treatment of human immunodeficiency virus infection with saquinavir, zidovudine and zalcitabine. New Engl. J. Med. 334 (1996), 1011–17CrossRefGoogle ScholarPubMed
Nachman, S. A., Stanley, K., Yogev, R.. Nucleoside analogs plus ritonavir in s antiretroviral-experienced Human Immunodeficiency Virus-infected children — a randomized controlled trial. J. Am. Med. Assoc. 283 (2000), 492–8CrossRefGoogle Scholar
Eastman, P. S., Shapiro, D. E., Coombs, R. W.. Maternal viral genotypic zidovudine resistance and infrequent failure of zidovudine therapy to prevent perinatal transmission of human immunodeficiency virus type 1 in pediatric Acquired Immune Deficiency Syndrome Clinical Trials Group Protocol 076. J. Infect. Dis. 177 3 (1998), 557–64CrossRefGoogle Scholar
McSherry, G. D., Shapiro, D. E., Coombs, R. W.. The effects of zidovudine in the subset of infants infected with human immunodeficiency virus type-1 (Pediatric Acquired Immune Deficiency Syndrome Clinical Trials Group Protocol 076). J. Pediatr., 134 6 (1999), 717–24CrossRefGoogle Scholar
Parker, M. M., Wade, N., Lloyd, R. M. Jr.. Prevalence of genotypic drug resistance among a cohort of Human Immunodeficiency Virus-infected newborns. J. Acquired Immune Deficiency Syndrome 32 3 (2003), 292–7CrossRefGoogle Scholar
Paediatric European Network for Treatment of Acquired Immune Deficiency Syndrome (The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome). Comparison of dual nucleoside-analogue reverse-transcriptase inhibitor regimens with and without nelfinavir in children with Human Immunodeficiency Virus-1 who have not previously been treated: the The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome 5 randomised trial. Lancet, 359 9308 (2002), 733–40CrossRef
Hetherington, S.Understanding drug hypersensitivity: what to look for when prescribing abacavir. Acquired Immune Deficiency Syndrome Reader 11 (2001), 620–2Google ScholarPubMed
Hewitt, R. G.Abacavir hypersensitivity reaction. Clin. Infect. Dis. 34 (2001), 1137–42CrossRefGoogle Scholar
Carr, A. & Cooper, D. A.Adverse effects of antiretroviral therapy. Lancet 356 (2000), 1423–30CrossRefGoogle ScholarPubMed
Coghlan, M. E., Sommadossi, J.-P., Jhala, N. C.. Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases. Clin. Infect. Dis. 33 (2001), 1914–21CrossRefGoogle ScholarPubMed
Saez-Llorens, X., Violari, A., Deetz, C. O.. Forty-eight-week evaluation of lopinavir/ritonavir, a new protease inhibitor, in human immunodeficiency virus-infected children. Pediatr. Infect. Dis. J. 22 3 (2003), 216–24CrossRefGoogle ScholarPubMed
Saez-Llorens, X., Violari, A., Deetz, C. O.. Fortyeight-week evaluation of lopinavir/ritonavir, a new protease inhibitor, in human immunodeficiency virus-nfected children. Pediatr. Infect. Dis. J. 22((3) (2003), 216–24
Krogstad, P., Lee, S., Johnson, G.. Nucleoside-analogue reverse transcriptase inhibitors plus nevirapine, nelfinavir, or ritonavir for pretreated children infected with human immunodeficiency virus type 1. Clin. Infect. Dis. 34 (2002), 991–1001CrossRefGoogle ScholarPubMed
Wiznia, A., Stanley, K., Krogstad, P.. Combination nucleoside-analogue reverse transcriptase inhibitor(s) plus nevirapine, nelfinavir, or ritonavir in stable, antiretroviral-experienced Human Immunodeficiency Virus-infected children: week 24 results of a randomized controlled trial — Pediatric Acquired Immune Deficiency Syndrome Clinical Trials Group 377. Acquired Immune Deficiency Syndrome Res. Hum. Retrovirus. 16 (2000), 1113–21Google Scholar
Floren, L. C., Wiznia, A., Hayashi, S.. Nelfinavir pharmacokinetics in stable human immunodeficiency virus-positive children: Pediatric Acquired Immune Deficiency Syndrome Clinical Trials Group protocol 377. Pediatrics 112 (2003), e220–227. URL: http://www.pediatrics.org/cgi/content/full/112/3/e220CrossRefGoogle Scholar
Rossum, A. M. C., Geelen, S. P. M., Hartwig, N. G., et al. Results of 2 years of treatment with protease inhibitor-containing antiretroviral therapy in Dutch children infected with human immunodeficiency virus type 1. Clin. Infect. Dis. 34 (2002), 1008–16CrossRefGoogle ScholarPubMed
Verweel, G., Rossum, A. M. C., Hartwig, N.. Treatment with highly active antiretroviral therapy in human immuno-deficiency virus type 1-infected children is associated with a sustained effect on growth. Pediatrics 109 2 (2002), E25 URL: http://www.pediatrics.org/cgi/content/full/109/2/e25CrossRefGoogle ScholarPubMed
Miller, T. L., Mawn, B. E., Orav, E. J.. The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children. Pediatrics 107 5) (2001), E77. URL: http://www.pediatrics.org/cgi/content/full/107/5/e77CrossRefGoogle ScholarPubMed
Jankelevich, S., Mueller, B. U., Mackall, C. L.. Long-term virologic and immunologic responses in human immunodeficiency virus type 1-infected children treated with indinavir, zidovudine and lamivudine. J. Infect. Dis. 183 (2001), 1116–20CrossRefGoogle ScholarPubMed
Starr, S. E., Fletcher, C. V., Spector, S. A.. Combination therapy with efavirenz, nelfinavir, and nucleoside reverse transcriptase inhibitors in children infected with human immuno-deficiency virus type 1. New Engl. J. Med. 341 (1999), 1874–81CrossRefGoogle Scholar
Staszewski, S., Morales-Ramirez, J., Tashima, K.. Efavirnez plus zidovudine and lamivudine, efavirenz plus indinavir, and indinavir plus zidovudine and lamivudine in the treatment of Human Immunodeficiency Virus-1 infection in adults. New Engl. J. Med. 341 (1999), 1865–73CrossRefGoogle ScholarPubMed
Friedl, A. C., Ledergerber, B., Flepp, M.. Response to first protease inhibitor- and efavirenz-containing antiretroviral combination therapy — the Swiss Human Immunodeficiency Virus Cohort Study. Acquired Immune Deficiency Syndrome 15 (2001), 1793–800Google ScholarPubMed
Starr, S. E., Fletcher, C. V., Spector, S. A.. Efavirenz liquid formulation in human immunodeficiency virus-infected children. Pediatr. Infect. Dis. J. 21 7 (2002) 659–63CrossRefGoogle ScholarPubMed
Verweel, G., Sharland, M., Lyall, H.. Nevirapine use in Human Immunodeficiency Virus-1-infected children. Acquired Immune Deficiency Syndrome 17 (2003), 1639–47Google Scholar
Saez-Llorens, X., Nelson, R. P., Emmanuel, P.. A randomized, double-blind study of triple nucleoside therapy of abacavir, lamivudine, and zidovudine versus lamivudine and zidovudine in previously treated human immunodeficiency virus type 1-infected children. Pediatrics 107 (2001), e4. URL: http://www.pediatric.org/cgi/content/full/107/1/e4CrossRefGoogle ScholarPubMed
Rossum, A. M., Dieleman, J. P., Fraaij, P. L.. Persistent sterile leukocyturia is associated with impaired renal function in human immunodeficiency virus type 1-infected children treated with indinavir. Pediatrics 110 2 (2002), e19CrossRefGoogle ScholarPubMed
Cozzi-Lepri, A., Phillips, A. N., Arminio Monforte, A.. Virologic and immunologic response to regimens containing nevirapine or efavirenz in combination with 2 nucleoside analogues in the Italian Cohort Naïve Antiretrovirals (I.Co.N.A.) study. J. Infect. Dis. 185 8 (2002), 1062–9CrossRefGoogle ScholarPubMed
Nunez, M., Soriano, V., Martin-Carbonero, L.. SENC (Spanish efavirenz vs. nevirapine comparison) trial: a randomized, open-label study in Human Immunodeficiency Virus-infected naïve individuals. Human Immunodeficiency Virus Clin. Trials 3(3) (2002), 186–94Google Scholar
Leth, F., Phanuphak, P., Ruxrungtham, K.. Comparison of first-line antiretroviral therapy with regimens including nevirapine, efavirenz, or both drugs, plus stavudine and lamivudine, a randomised open-label trial, the 2NN Study. Lancet 363(9417) (2004), 1253–63CrossRefGoogle ScholarPubMed
Sulkowski, M. S., Thomas, D. L., Mehta, S. H.. Hepatotoxicity associated with nevirapine or efavirenz-containing antiretroviral therapy: role of hepatitis C and B infections. Hepatology 35 1 (2002), 182–9CrossRefGoogle ScholarPubMed
Saavedra, J., McCoig, C., Mallory, M. et al. Clinical experience with triple nucleoside (NRTI) combination Zidovudine (also Known as AZT)/Lamivudine/abacavir (Abacavir) as initial therapy in Human Immunodeficiency Virus-infected children. In 41st Interscience Conference on Antimicrobial Agents and Chemotherapy. (September 22–25, 2001, Chicago, Interleukin [Abstract 1941]
Wells, C. J., Sharland, M., Smith, C. J. et al. Triple nucleoside analogue therapy with zidovudine (Zidovudine (also known as Zidovudine (also Known as AZT))), lamivudine (Lamivudine), and abacavir (Abacavir) in the paediatric Human Immunodeficiency Virus London South Network (PHILS-NET) cohort. In XIV International Acquired Immune Deficiency Syndrome Conference. July 7–12, 2002, Barcelona, Spain [Abstract TuPeB4625]
Paediatric European Network for Treatment of Acquired Immune Deficiency Syndrome (The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome). Comparison of dual nucleoside analogue reverse transcriptase inhibitor regimens with and without nelfinavir in children with Human Immunodeficiency Virus-1 who have not previously been treated: the The Pediatric European Network for the Treatment of Acquired Immune Deficiency Syndrome 5 randomised trial. Lancet 359 (2002), 733–40CrossRef
Kline, M. W., Brundage, R. C., Fletcher, C. V.. Combination therapy with saquinavir soft gelatin capsules in children with human immunodeficiency virus infection. Pediatr. Infect. Dis. J. 20 (2001), 666–71CrossRefGoogle ScholarPubMed
Grub, S., DeLora, P., Ludin, E.. Pharmacokinetics and pharmacodynamics of saquinavir in pediatric patients with human immunodeficiency virus infection. Clin. Pharmacol. Ther. 71 (2002), 122–30CrossRefGoogle ScholarPubMed
Hoffmann, F., Notheis, G., Wintergerst, U.. Comparison of ritonavir plus saquinavir- and nelfinavir plus saquinavir-containing regimens as salvage therapy in children with human immunodeficiency virus type 1 infection. Pediatr. Infect. Dis. J. 19 (2000), 47–51CrossRefGoogle Scholar
Moyle, G.Use of Human Immunodeficiency Virus protease inhibitors as pharmacoenhancers. Acquired Immune Deficiency Syndrome Reader February (2001), 87–98Google ScholarPubMed
Church, J. A., Cunningham, C., Hughes, M.. Safety and antiretroviral activity of chronic subcutaneous administration of T-20 in human immunodeficiency virus 1-infected children. Pediatr. Infect. Dis. J. 21 (2002), 653–9CrossRefGoogle ScholarPubMed
Rossum, A. M. C., Groot, R., Hartwig, N. G.. Pharmacokinetics of indinavir and low-dose ritonavir in children with Human Immunodeficiency Virus-1 infection. Acquired Immune Deficiency Syndrome 14 (2000), 2209–19Google Scholar
Shearer, W. T., Quinn, T. C., LaRussa, P.. Viral load and disease progression in infants infected with human immuno-deficiency virus type 1. New Engl. J. Med. 336 (1997), 1337–42CrossRefGoogle Scholar
McIntosh, K., Shevitz, A., Zaknun, D.. Age- and time-related changes in extracellular viral load in children vertically infected by human immunodeficiency virus. Pediatr. Infect. Dis. J. 15 (1996), 1087–91CrossRefGoogle ScholarPubMed
Marschner, I. C., Collier, A. C., Coombs, R. W.. Use of changes in plasma levels of human immunodeficiency virus type 1 Ribonucleic Acid to assess the clinical benefit of antiretroviral therapy. J. Infect. Dis. 177 (1998), 40–7CrossRefGoogle ScholarPubMed
Connors, M., Kovacs, J. A., Krevat, S.. Human Immunodeficiency Virus infection induces changes in Cluster of Differentiation4+ T-cell phenotype and depletions within the Cluster of Differentiation4+ T cell repertoire that are not immediately restored by antiviral or immune-based therapies. Nat. Med. 3 (1997), 533–40CrossRefGoogle ScholarPubMed
Barnhart, H. X., Caldwell, M. B., Thomas, P.. Natural history of human immunodeficiency virus disease in perinatally infected children: an analysis from the Pediatric Spectrum of Disease Project. Pediatrics 97 (1996), 710–6Google ScholarPubMed
Durant, J., Clevenbergh, P., Halfon, P.. Drug-resistance genotyping in Human Immunodeficiency Virus-1 therapy: the VIRADAPT randomised controlled trial. Lancet 353 (1999), 2195–9CrossRefGoogle ScholarPubMed
Cohen, C. J., Hunt, S., Sension, M.. A randomized trial assessing the impact of phenotypic resistance testing on antiretroviral therapy. Acquired Immune Deficiency Syndrome 16 (2002), 579–88Google ScholarPubMed
Cingolani, A., Antinori, A., Rizzo, M. G.. Usefulness of monitoring Human Immunodeficiency Virus drug resistance and adherence in individuals failing highly active antiretroviral therapy: a randomized study (ARGENTA). Acquired Immune Deficiency Syndrome 16 (2002), 369–79Google Scholar
Meynard, J.-L., Vray, M., Morand-Joubert, L.. Phenotypic or genotypic resistance testing for choosing antitretroviral therapy after treatment failure: a randomized trial. Acquired Immune Deficiency Syndrome 16 (2002), 727–36Google ScholarPubMed
Yeni, P. G., Hammer, S. M., Carpenter, C. J.. Antiretroviral treatment for adult Human Immunodeficiency Virus infection in 2002: updated re-commendations of the International Acquired Immune Deficiency Syndrome Society-USA Panel. J. Am. Med. Assoc. 288 (2002), 222–35CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Initiating and changing antiretroviral therapy
    • By Lynne M. Mofenson, Chief, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH, Rockville, MD, Leslie K. Serchuck, Medical Officer, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH Rockville, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.025
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Initiating and changing antiretroviral therapy
    • By Lynne M. Mofenson, Chief, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH, Rockville, MD, Leslie K. Serchuck, Medical Officer, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH Rockville, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.025
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Initiating and changing antiretroviral therapy
    • By Lynne M. Mofenson, Chief, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH, Rockville, MD, Leslie K. Serchuck, Medical Officer, Pediatric, Adolescent and Maternal AIDS Branch, Center for Research for Mothers and Children, NIH Rockville, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.025
Available formats
×