Therapeutic potential of chloroquine added to zidovudine plus didanosine for HIV-1 infected children.

OBJECTIVE: To evaluate the efficacy and safety of CHQ in a combination treatment with ZDV/ddI in HIV-1-infected children. MATERIAL AND METHOD: Fifty five HIV-infected children were randomly enrolled into 3 treatment groups: (I) ZDV + ddI (n = 25); and (II) ZDV + ddI + CHQ (n = 21); and (III) ZDV + ddI experienced children were non-randomly added CHQ (n = 9). Weight, CD4+ T-lymphocytes and plasma HIV-RNA were measured at weeks 0, 8 and 24. RESULTS: Fifteen, 16 and 8 children from Groups I, II and III were evaluated. No significant improvement in the mean Z-score for weight in groups I and II, but a decrease occurred in group III after 6 months of therapy. In group I, II and III, the respective change in the mean CD4+ T-lymphocyte percentage was +6.7, +4.0 and -0.6. The decrease in the plasma HIV-RNA log was 0.9, 1.1 and 0.7, respectively. There was a trend for more nausea/vomiting in group II/III and more opportunistic infections in group III. CONCLUSION: 1. The addition of chloroquine in ZDV/ddI regimen provided no significant improvement in clinical, immunological and virological parameters. 2. Chloroquine induced immunosuppression and nausea complicated its use.

Costs of medical services for patients with HIV/AIDS in Khon Kaen, Thailand.

OBJECTIVE: To estimate the savings and cost of providing highly active antiretroviral therapy (HAART) to adult patients with AIDS under Universal Coverage (UC) in Khon Kaen Province, Thailand. DESIGN: Micro-costing of outpatient and inpatient services of two referral hospitals, and cost modelling. SETTING: Khon Kaen Regional Hospital and Northeast Regional Infectious Hospital. PATIENTS: Adult patients who resided in Khon Kaen and made outpatient visits at and/or those who were discharged from those hospitals from 1 December 2001 to 28 February 2002. MAIN OUTCOME MEASURE: The average cost per outpatient visit and per inpatient day. Based on these figures, the savings and cost of providing HAART to adult patients with AIDS under UC at outpatient settings in this province were estimated. RESULTS: The average cost per outpatient visit with and without antiretroviral drugs (ARV) was US$294.2 and US$26.1, respectively. The average cost per inpatient day with and without ARV drugs was US$368.1 and US$43.8, respectively. The net annual cost of HAART was estimated to be US$5 674 629. This is equivalent to 20.0% of the annual UC budget for adults in this province in 2002. Sensitivity analysis and projection to the year 2006 were conducted. CONCLUSION: A large increase in the budget would be required to provide HAART to all adult patients with AIDS under UC. However, the sensitivity analysis showed it would be an affordable policy option if low-cost antiretroviral drugs were successfully introduced. This type of analysis would be useful to assess the financial implications of providing HAART in public health systems worldwide.

Therapeutic potential of chloroquine added to zidovudine plus didanosine for HIV-1 infected children.

OBJECTIVE: To evaluate the efficacy and safety of CHQ in a combination treatment with ZDV/ddI in HIV-1-infected children. MATERIAL AND METHOD: Fifty five HIV-infected children were randomly enrolled into 3 treatment groups: (I) ZDV + ddI (n = 25); and (II) ZDV + ddI + CHQ (n = 21); and (III) ZDV + ddI experienced children were non-randomly added CHQ (n = 9). Weight, CD4+ T-lymphocytes and plasma HIV-RNA were measured at weeks 0, 8 and 24. RESULTS: Fifteen, 16 and 8 children from Groups I, II and III were evaluated. No significant improvement in the mean Z-score for weight in groups I and II, but a decrease occurred in group III after 6 months of therapy. In group I, II and III, the respective change in the mean CD4+ T-lymphocyte percentage was +6.7, +4.0 and -0.6. The decrease in the plasma HIV-RNA log was 0.9, 1.1 and 0.7, respectively. There was a trend for more nausea/vomiting in group II/III and more opportunistic infections in group III. CONCLUSION: 1. The addition of chloroquine in ZDV/ddI regimen provided no significant improvement in clinical, immunological and virological parameters. 2. Chloroquine induced immunosuppression and nausea complicated its use.