Nucleoside Analogs Plus Ritonavir in Stable Antiretroviral Therapy--Experienced HIV-Infected Children: A Randomized Controlled Trial

Article Abstract:

Many HIV-infected children might benefit from taking a protease inhibitor. Protease inhibitors have improved the health of adult HIV patients but have never been tested on children. Researchers randomly assigned 297 HIV-infected children to take 2 nucleoside analogs, 1 nucleoside analog plus a protease inhibitor, or 2 nucleoside analogs plus a protease inhibitor. Twelve weeks later, half the patients in both protease inhibitor groups had undetectable virus levels compared to 12% of those taking 2 nucleoside analogs. At 48 weeks, more children taking 2 nucleoside analogs and a protease inhibitor had undetectable levels than those taking 1 nucleoside analog and a protease inhibitor.

HIV infection in children, Protease inhibitors, Pediatric HIV infections

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A multicenter trial of oral zidovudine in children with advanced human immunodeficiency virus disease

Article Abstract:

The human immunodeficiency virus (HIV) is the causative agent of AIDS. Clinical drug trials have shown that zidovudine (formerly called azidothymidine, or AZT) is effective for the treatment of HIV infection in adults. In order to evaluate the safety, tolerance and effectiveness of zidovudine in children, 88 children (mean age of 4 years) with advanced HIV disease were treated with zidovudine. The first phase of the study included 24 weeks of drug treatment (180 milligrams per square meter of body surface area given every six hours), and those who completed the first phase were allowed to continue receiving zidovudine. During the course of the study, 14 children died due to either pneumonia, lung failure, tuberculosis or heart failure. Sixty-one of the children completed the first phase and 49 of these children continued receiving zidovudine for up to 90 weeks. Sixty-one percent of the children experienced some form of blood toxicity, occurring as anemia (low red blood cell count) in 26 percent of the cases, or neutropenia (low white blood cell count) in 48 percent. Most of these conditions disappeared by themselves. However, 30 children had to have the dose of the drug reduced or required blood transfusions. There were only three cases where drug treatment was stopped because of blood toxicity. Drug treatment with zidovudine resulted in an improvement in mental function and weight gain, and in increase in the number of cerebrospinal fluid cultures that tested negative for HIV. It is concluded that the dose of zidovudine used in this study is can be used safely in children with advanced HIV disease. The clinical improvements observed in this study are similar to those reported previously for zidovudine drug trials in adults infected with HIV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, HIV infection, HIV infections, AIDS (Disease) in children, Pediatric AIDS (Disease)

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Lack of Long-term Effects of In Utero Exposure to Zidovudine Among Uninfected Children Born to HIV-Infected Women

Article Abstract:

Children who were exposed to zidovudine in the womb because their mother was infected with HIV do not appear to develop any serious health problems. Researchers followed 234 children born to mothers who took zidovudine or a placebo during pregnancy for up to five years. Most of the children exposed to zidovudine had no serious health problems and had nornal heights and weights as well as normal intellectual development. However, two children had unusual visual problems and one had asymptomatic heart disease. Physicians will continue to follow these children to detect any unusual health problems.

United States, Health aspects, Maternal-fetal exchange, Fetus

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