Thursday, July 26, 2012

HIV and children: new treatments look promising

Celia Christie-Samuels and Bernard P├ęcoul, 
co-chairs of the Catching children before they fall satellite session.
New treatment options may soon be available for HIV-positive children and adolescents.

Treatment options for babies and children are currently more limited than those available to adults, and there is a need for new drugs to treat this group.
A new paediatric formulation of tenofovir (Viread) was shown to be a safe treatment for the prevention of mother-to-child transmission of HIV. A single 600mg dose of tenofovir was given to pregnant women during labour. Infants were treated with a daily 6mg/kg dose of tenofovir for seven days. Good concentrations of the drug were achieved and it caused no serious side-effects.
Results of a study looking at the safety and efficacy of therapy based on the ritonavir-boosted protease inhibitor fosamprenavir (Telzir/Lexiva) were also presented to the conference. After 48 weeks of treatment, up to 78% of children achieved an undetectable viral load. The safety profile of the drug was similar to that seen in adults.
Forty-eight week results from a study investigating the use of raltegravir (Isentress), in combination with other anti-HIV drugs, showed that it suppressed viral load to below 50 in 57% of patients and that CD4 cell count increased by over 150 cells/mm3. On the basis of these results, an application has been made in the US for a licence to use the drug in HIV-positive children and adolescents.
The experimental integrase inhibitor dolutegravir also did well in a small study involving children aged between 2 and 18 years of age. After four weeks of treatment, 70% of patients had a viral load below 40 copies/ml and the treatment also achieved good increases in CD4 cell percentage.
The effectiveness of etravirine was monitored in highly-treatment experienced children. After a year of therapy with a combination that included the drug, 56% had an undetectable viral load.

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