Important note: Information in this article was accurate in August 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; August 19, 2002
Michael Greer, Senior Medical Writer
Ann J. Melvin and colleagues at the University of Washington in Seattle and Oregon Health Sciences University in Portland conducted a study to "characterize the long-term tolerance and virologic efficacy of combination antiretroviral therapy consisting of four or more agents in a clinical setting."
These antiretroviral regimens provided a high degree of viral suppression with mild toxicity, Melvin and coauthors found.
The researchers reviewed data from a group of 36 pediatric HIV patients treated with highly active antiretroviral therapy (HAART). While most HAART regimens are comprising three agents, study participants were given up to five reverse transcriptase and protease inhibitors, they said. Treatment was individualized to each child based on their previous drug exposure and viral genotype.
Almost 90% of the study cohort carried undetectable levels of viral RNA after four- or five-drug HAART, according to the report. Moreover, almost 80% of treated children maintained undetectable viral loads for a median of more than 2 years.
Drug toxicity was mild, usually manifesting as neutropenia or elevated alanine aminotransferase levels (Efficacy and toxicity of antiretroviral therapy using 4 or more agents. Archives of Pediatric and Adolescent Medicine Jun 2002;156(6):568-573).
"Treatment with four or five antiretroviral agents was well tolerated in HIV-1 infected children and resulted in a high degree of viral suppression, even in children with previous antiretroviral drug experience," Melvin and colleagues concluded.
The corresponding author for this report is Ann J. Melvin, Children's Hospital and Regional Medical Center, 4800 Sandpoint Way NE, CH-32, Seattle, WA 98105 USA. E-mail: amelvi@chmc.org.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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