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Treatment of children with HIV infection

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Abstract

The treatment of pediatric HIV infection has seen vast improvements in terms of better long-term suppression of HIV replication and subsequent improvements in the longevity and quality of life in children. This has been realized, in part, by development of newer antiretroviral medications, better knowledge about the pharmacokinetics of these drugs in children, and improved insight on drug toxicities in children. This review will discuss some of the newer agents that may be available for children in the near future, in addition to new pharmacokinetic and toxicity data that are specific to the pediatric patient. New information on key vaccines that should be administered to children with HIV infection is also discussed.

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References and Recommended Reading

  1. Gona P, Van Dyke RB, Williams PL, et al.: Incidence of opportunistic and other infections in HIV-infected children in the HAART era. JAMA 2006, 296:292–300.

    Article  PubMed  CAS  Google Scholar 

  2. Resino S, Resino R, Maria Bellon J, et al.: Clinical outcomes improve with highly active antiretroviral therapy in vertically HIV type-1-infected children. Clin Infect Dis 2006, 43:243–252.

    Article  PubMed  Google Scholar 

  3. Wang LH, Wiznia AA, Rathore MH, et al.: Pharmacokinetics and safety of single oral doses of emtricitabine in human immunodeficiency virus-infected children. Antimicrob Agents Chemother 2004, 48:183–191.

    Article  PubMed  CAS  Google Scholar 

  4. Hazra R, Balis FM, Tullio AN, et al.: Single-dose and steady-state pharmacokinetics of tenofovir disoproxil fumarate in human immunodeficiency virus-infected children. Antimicrob Agents Chemother 2004, 48:124–129.

    Article  PubMed  CAS  Google Scholar 

  5. Gafni RI, Hazra R, Reynolds JC, et al.: Tenofovir disoproxil fumarate and an optimized background regimen of antiretroviral agents as salvage therapy: impact on bone mineral density in HIV-infected children. Pediatrics 2006, 118:e711–718.

    Article  PubMed  Google Scholar 

  6. Storm DS, Boland MG, Gortmaker SL, et al.: Protease inhibitor combination therapy, severity of illness, and quality of life among children with perinatally acquired HIV-1 infection. Pediatrics 2005, 115:e173–182.

    Article  PubMed  Google Scholar 

  7. Lee GM, Gortmaker SL, McIntosh K, et al.: Quality of life for children and adolescents: impact of HIV infection and antiretroviral treatment. Pediatrics 2006, 117:273–283.

    Article  PubMed  Google Scholar 

  8. Hicks CB, Cahn P, Cooper DA, et al.: Durable efficacy of tipranavir-ritonavir in combination with an optimised background regimen of antiretroviral drugs for treatment-experienced HIV-1-infected patients at 48 weeks in the Randomized Evaluation of Strategic Intervention in multi-drug reSistant patients with Tipranavir (RESIST) studies: an analysis of combined data from two randomised open-label trials. Lancet 2006, 368:466–475.

    Article  PubMed  CAS  Google Scholar 

  9. Tipranavir [package insert]. Ridgefield, CT: Boehringer Ingelheim Pharmaceutics, Inc.; 2006.

  10. Salazar J, Cahn P, Della Negra M, et al.: Efficacy and safety of tipranavir co-administered with ritonavir in HIV-infected children and adolescents [abstract WeAB0301]. Program and abstracts of the XVI International AIDS Conference. Toronto, Canada; August 13–18, 2006.

  11. Sabo J, Cahn P, Della Negra M, et al.: Population pharmacokinetic assessment of systemic steady-state tipranavir concentrations for HIV+ pediatric patients administered tipranavir/ritonavir: BI 1182.14 and PACTG 1051 Study Team. Presented at the 13th Conference on Retroviruses and Opportunistic Infections. Denver, CO: February 5–8, 2006.

  12. Cervia JS, Smith MA: Enfuvirtide (T-20): a novel human immunodeficiency virus type 1 fusion inhibitor. Clin Infect Dis 2003, 37:1102–1106.

    Article  PubMed  CAS  Google Scholar 

  13. Nelson M, Arasteh K, Clotet B, et al.: Durable efficacy of enfuvirtide over 48 weeks in heavily treatment-experienced HIV-1-infected patients in the T-20 versus optimized background regimen only 1 and 2 clinical trials. J Acquir Immune Defic Syndr 2005, 40:404–412.

    Article  PubMed  CAS  Google Scholar 

  14. Church JA, Cunningham C, Hughes M, et al.: Safety and antiretroviral activity of chronic subcutaneous administration of T-20 in human immunodeficiency virus 1-infected children. Pediatr Infect Dis J 2002, 21:653–659.

    Article  PubMed  Google Scholar 

  15. DeJesus E, Berger D, Markowitz M, et al.: Antiviral activity, pharmacokinetics, and dose response of the HIV-1 integrase inhibitor GS-9137 (JTK-303) in treatment-naive and treatment-experienced patients. J Acquir Immune Defic Syndr 2006, 43:1–5.

    Article  PubMed  CAS  Google Scholar 

  16. Grinsztejn B, Nguyen Y, Katlama C, et al.: Potent antiretroviral effect of MK-0518, a novel HIV-1 integrase inhibitor, in patients with triple-class resistant virus. Presented at the 13th Conference on Retroviruses and Opportunistic Infections. Denver, CO; February 5–8, 2006.

  17. Menson EN, Walker AS, Sharland M, et al.: Underdosing of antiretrovirals in UK and Irish children with HIV as an example of problems in prescribing medicines to children, 1997–2005: cohort study. BMJ 2006, 332:1183–1187.

    Article  PubMed  Google Scholar 

  18. Kline MW, Blanchard S, Fletcher CV, et al.: A phase I study of abacavir (1592U89) alone and in combination with other antiretroviral agents in infants and children with human immunodeficiency virus infection. AIDS Clinical Trials Group 330 Team. Pediatrics 1999, 103:e47.

    Article  PubMed  CAS  Google Scholar 

  19. Paediatric European Network for Treatment of AIDS: Comparison of dual nucleoside-analogue reverse-transcriptase inhibitor regimens with and without nelfinavir in children with HIV-1 who have not previously been treated: the PENTA 5 randomised trial. Lancet 2002, 359:733–740.

    Article  Google Scholar 

  20. Bergshoeff A, Burger D, Verweij C, et al.: Plasma pharmacokinetics of once-versus twice-daily lamivudine and abacavir: simplification of combination treatment in HIV-1-infected children (PENTA-13). Antivir Ther 2005, 10:239–246.

    PubMed  CAS  Google Scholar 

  21. LePrevost M, Green H, Flynn J, et al.: Adherence and acceptability of once daily lamivudine and abacavir in human immunodeficiency virus type-1 infected children. Pediatr Infect Dis J 2006, 25:533–537.

    Article  PubMed  Google Scholar 

  22. Yogev R, Kovacs A, Chadwick EG, et al.: Single-dose safety and pharmacokinetics of amprenavir (141W94), a human immunodeficiency virus type 1 (HIV-1) protease inhibitor, in HIV-infected children. Antimicrob Agents Chemother 2005, 49:336–341.

    Article  PubMed  CAS  Google Scholar 

  23. Cunningham C, Freedman A, Read S, et al.: Safety and antiviral activity of fosamprenavir (FPV)-containing regimens in HIV-infected 2–18 year old pediatric subjects (interim data, Study APV29005). Presented at the 14th Conference on Retroviruses and Opportunistic Infections. Los Angeles, CA; February 25–28, 2007.

  24. Chadwick E, Borkowsky W, Fortuny Guasch C, et al.: Safety and antiviral activity of fosamprenavir/ritonavir (FPV/RTV) qd regimens in HIV-infected pediatric subjects ages 2–18 years (48 week interim data, Study APV20003). Presented at the 14th Conference on Retroviruses and Opportunistic Infections. Los Angeles, CA; February 25–28, 2007.

  25. Resino S, Bellon JM, Munoz-Fernandez MA: Antiretroviral activity and safety of lopinavir/ritonavir in protease inhibitor-experienced HIV-infected children with severemoderate immunodeficiency. J Antimicrob Chemother 2006, 57:579–582.

    Article  PubMed  CAS  Google Scholar 

  26. Rosso R, Di Biagio A, Dentone C, et al.: Lopinavir/ritonavir exposure in treatment-naive HIV-infected children following twice or once daily administration. J Antimicrob Chemother 2006, 57:1168–1171.

    Article  PubMed  CAS  Google Scholar 

  27. Rutstein R, Samson P, Aldrovandi G, et al.: Effect of atazanavir on serum cholesterol and triglyceride levels in HIV-infected infants, children, and adolescents: PACTG 1020A. Presented at the 12th Conference on Retroviruses and Opportunistic Infections. Boston, MA: February 22–25, 2005.

  28. Kiser J, Rutstein R, Aldrovandi G, et al.: Pharmacokinetics of atazanavir/ritonavir in HIV-infected infants, children, and adolescents: PACTG 1020A. Presented at the 12th Conference on Retroviruses and Opportunistic Infections. Boston, MA; February 22–25, 2005.

  29. Van Rompay KK, Brignolo LL, Meyer DJ, et al.: Biological effects of short-term or prolonged administration of 9-[2-(phosphonomethoxy)propyl]adenine (tenofovir) to newborn and infant rhesus macaques. Antimicrob Agents Chemother 2004, 48:1469–1487.

    Article  PubMed  Google Scholar 

  30. Castillo AB, Tarantal AF, Watnik MR, Martin RB: Tenofovir treatment at 30 mg/kg/day can inhibit cortical bone mineralization in growing rhesus monkeys (Macaca mulatta). J Orthop Res 2002, 20:1185–1189.

    Article  PubMed  CAS  Google Scholar 

  31. Hazra R, Gafni RI, Maldarelli F, et al.: Tenofovir disoproxil fumarate and an optimized background regimen of antiretroviral agents as salvage therapy for pediatric HIV infection. Pediatrics 2005, 116:e846–854.

    Article  PubMed  Google Scholar 

  32. McKinney RE Jr, Rodman J, Hu C, et al.: A phase I–II study of a once-daily regimen of emtricitabine, didanosine, and efavirenz in HIV-infected, therapy naive children and adolescents (Pediatric AIDS Clinical Trials Group Protocol P1021). Pediatrics 2007, In press.

  33. De Santis M, Carducci B, De Santis L, et al.: Periconceptional exposure to efavirenz and neural tube defects. Arch Intern Med 2002, 162:355.

    Article  PubMed  Google Scholar 

  34. Saitoh A, Hull AD, Franklin P, Spector SA: Myelomeningocele in an infant with intrauterine exposure to efavirenz. J Perinatol 2005, 25:555–556.

    Article  PubMed  Google Scholar 

  35. Levin MJ, Gershon AA, Weinberg A, et al.: Administration of live varicella vaccine to HIV-infected children with current or past significant depression of CD4(+) T cells. J Infect Dis 2006, 194:247–255.

    Article  PubMed  Google Scholar 

  36. Weinberg A, Gona P, Nachman SA, et al.: Antibody responses to hepatitis A virus vaccine in HIV-infected children with evidence of immunologic reconstitution while receiving highly active antiretroviral therapy. J Infect Dis 2006, 193:302–311.

    Article  PubMed  CAS  Google Scholar 

  37. Moscicki AB, Ellenberg JH, Vermund SH, et al.: Prevalence of and risks for cervical human papillomavirus infection and squamous intraepithelial lesions in adolescent girls: impact of infection with human immunodeficiency virus. Arch Pediatr Adolesc Med 2000, 154(2):p. 127–34.

    PubMed  CAS  Google Scholar 

  38. Hagensee ME, Cameron JE, Leigh JE, Clark RA: Human papillomavirus infection and disease in HIV-infected individuals. Am J Med Sci 2004, 328:57–63.

    Article  PubMed  Google Scholar 

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Correspondence to Terry C. Dixon MD, PhD.

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Dixon, T.C., Cunningham, C.K. Treatment of children with HIV infection. Curr HIV/AIDS Rep 4, 93–99 (2007). https://doi.org/10.1007/s11904-007-0014-9

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