Etravirine-based highly active antiretroviral therapy in HIV-1-infected paediatric patients
| Autor: | María Ángeles Muñoz-Fernández, M.I. de José, Verónica Briz, S Jiménez de Ory, Claudia Palladino, E Núñez-Cuadros, Juan Antonio León, María Isabel González-Tomé, JT Ramos, M L Navarro |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
business.industry Health Policy Human immunodeficiency virus (HIV) Etravirine Retrospective cohort study medicine.disease_cause Antiretroviral therapy Surgery Regimen Infectious Diseases Tolerability Interquartile range Internal medicine medicine Pharmacology (medical) business medicine.drug Paediatric patients |
| Zdroj: | HIV Medicine. 12:442-446 |
| ISSN: | 1464-2662 |
| DOI: | 10.1111/j.1468-1293.2010.00907.x |
| Popis: | Background We evaluated the efficacy, safety and tolerability of etravirine in paediatric patients vertically infected with HIV-1. Methods A multicentre retrospective study of 23 multidrug-resistant paediatric patients (five children and 18 adolescents) enrolled in the study from 1 September 2007 to 28 February 2010 was carried out. We performed a longitudinal analysis of immunological, virological and clinical data. Results The median age of the patients was 14.2 years [interquartile range (IQR) 12.5–15.8 years]. At baseline, the median HIV-1 RNA was 29 000 (4.5 log10) HIV-1 RNA copies/mL (range 4300-83 000 copies/mL), the median CD4 T-cell count was 445 cells/μL (range 221–655 cells/μL) and the median CD4 percentage was 19.6% (IQR 13.0-31.0). Remarkably, 16 of 23 patients (70%) harboured one or more etravirine-associated resistance mutations. The backbone regimen included at least two fully active drugs in 91% of patients. After etravirine-based therapy, 20 patients (87%) achieved HIV-1 RNA 120 weeks. Three mild/short-term and two moderate skin rashes were observed in the adolescents. Laboratory abnormalities included hypercholesterolaemia (11 of 23 patients), hypertriglyceridaemia (eight of 23 patients), and reduced high-density lipoprotein cholesterol (10 of 23 patients). Adherence was complete in seven patients (30%). No patients showed complete resistance to etravirine after follow-up. However, three of 21 patients (14%) who initially showed intermediate resistance interrupted etravirine treatment because of virological failure. Conclusions We observed a sustained antiviral response and improved immunological parameters in multidrug-resistant paediatric patients, most of whom had received etravirine as part of salvage regimens with at least two fully active drugs. |
| Databáze: | OpenAIRE |
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