Salvage therapy with abacavir and other reverse transcriptase inhibitors for human immunodeficiency-associated encephalopathy.
Pediatr Infect Dis J
; 25(12): 1142-52, 2006 Dec.
Article
em En
| MEDLINE
| ID: mdl-17133160
ABSTRACT
BACKGROUND:
HIV-associated encephalopathy (HIV-AE) is a severe neurologic condition that affects HIV-infected children. The potential benefit of antiretroviral (ARV) agents with good cerebrospinal fluid (CSF) penetration remains to be defined. Abacavir (ABC) achieves good CSF concentrations and studies of high-dose ABC showed benefit in adults with HIV dementia. The present study evaluated the safety and virologic, immunologic and neuropsychological responses of an ARV regimen including high-dose ABC in children with HIV-AE.METHODS:
Children between 3 months and 18 years old and abacavir-naive with HIV-AE and virologic failure were eligible.RESULTS:
Seventeen children (16 ARV-experienced) were enrolled and 14 children completed 48 weeks of therapy. The overall tolerability was good; 2 children had a possible hypersensitivity reaction. At week 48, 53% and 59% of the children achieved HIV RNA levels below the limit of quantitation in plasma and CSF, respectively. The median (25%-75% range) change of HIV RNA from baseline to week 48 was -2.29 (-0.81 to -2.47) log10 copies/mL in plasma and -0.94 (0 to -1.13) log10 copies/mL in CSF. The mean increases in CD4 (+/-standard error of mean) cell count and CD4% were 427 (+/-169) cells/mm and 8% (+/-2), respectively. Concentrations of soluble tumor necrosis factor receptor II were reduced in plasma and CSF. Children less than 6 years of age demonstrated significant neuropsychological improvement at week 48.CONCLUSIONS:
In the present study with a limited number of children, highly active ARV therapy including high-dose ABC showed a safety profile similar to standard dose ABC and provided clinical, immunologic and virologic response in children with HIV-AE at week 48. Children less than 6 years of age also demonstrated significant neuropsychological improvement.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Didesoxinucleosídeos
/
Complexo AIDS Demência
/
Terapia de Salvação
/
Fármacos Anti-HIV
Tipo de estudo:
Clinical_trials
/
Risk_factors_studies
Limite:
Adolescent
/
Child
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Child, preschool
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Female
/
Humans
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Infant
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Male
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article