Antiretroviral regimen associated with less virological failure among HIV-infected children

April 30, 2013

Elizabeth D. Lowenthal, M.D., M.S.C.E., of the University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, and colleagues conducted a study to determine whether there was a difference in time to virological failure between HIV-infected children initiating nevirapine vs. efavirenz-based antiretroviral treatment in Botswana.

"More than 2 million children worldwide are infected with (HIV), approximately 90 percent of whom live in sub-Saharan Africa," according to background information in the article. "Worldwide, the nonnucleoside reverse transcriptase inhibitors (NNRTIs) efavirenz and are commonly used in first-line antiretroviral regimens in both adults and children with . Data on the of these medications in children are limited. … Most countries favor nevirapine-based regimens for the majority of children due to perceived comparable effectiveness at lower cost."

The study included children (3-16 years of age) who initiated efavirenz-based (n=421) or nevirapine-based (n=383) treatment between April 2002 and January 2011 at a large pediatric HIV care setting in Botswana. The primary outcome was time from initiation of therapy to virological failure, defined as lack of plasma HIV RNA suppression to less than 400 copies/mL by 6 months or confirmed HIV RNA of 400 copies/mL or greater after suppression.

With a median (midpoint) follow-up time of 69 months, the researchers found that 57 children (13.5 percent) initiating treatment with efavirenz and 101 children (26.4 percent) initiating treatment with nevirapine had virological failure. There were 11 children (2.6 percent) receiving efavirenz and 20 children (5.2 percent) receiving nevirapine who never achieved virological suppression.

"In this large cohort of children infected with HIV, time to virological failure was longer among children receiving efavirenz vs. nevirapine. With the majority of the world's receiving nevirapine-based antiretroviral therapy, these findings may have significant public health importance," the authors write. "… more work should be done to make efavirenz a cost-effective option for pediatric programs in resource-limited settings."

Explore further: New drug adds to arsenal against AIDS

More information: JAMA. 2013;309[17]:1803-1809

Related Stories

New drug adds to arsenal against AIDS

July 15, 2011
A new drug, rilpivirine, can add powerfully to the combination of medications used to control HIV for first-time patients, researchers conclude in Friday's issue of The Lancet.

Nevirapine based treatment is effective in African women, but not optimal

June 12, 2012
(Medical Xpress) -- According to new research from Brigham and Women’s Hospital (BWH), an anti-AIDS treatment regimen, which includes the WHO-recommended drug nevirapine, is just as effective at suppressing the HIV virus ...

Recommended for you

New injectable antiretroviral treatment proved to be as effective as standard oral therapy

August 3, 2017
Intramuscularly administered antiretroviral therapy (ART) may be as effective for HIV treatment as current oral therapies. This is the main conclusion of a Phase II clinical trial carried out by 50 research centers around ...

Research finds home-based kit would increase HIV testing

July 31, 2017
Research led by William Robinson, PhD, Associate Research Professor of Behavioral & Community Health Sciences at LSU Health New Orleans School of Public Health, has found that 86% of heterosexuals who are at high risk for ...

Scientists divulge latest in HIV prevention

July 25, 2017
A far cry from the 1990s "ABC" campaign promoting abstinence and monogamy as HIV protection, scientists reported on new approaches Tuesday allowing people to have all the safe sex they want.

Girl's HIV infection seems under control without AIDS drugs

July 24, 2017
A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines—more evidence that early treatment can occasionally cause a long remission that, ...

Meds by monthly injection might revolutionize HIV care (Update)

July 24, 2017
Getting a shot of medication to control HIV every month or two instead of having to take pills every day could transform the way the virus is kept at bay.

Candidate AIDS vaccine passes early test

July 24, 2017
The three-decade-old quest for an AIDS vaccine received a shot of hope Monday when developers announced that a prototype triggered the immune system in an early phase of human trials.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.