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Erschienen in: European Journal of Pediatrics 4/2009

01.04.2009 | Review

Clinical practice treatment of HIV infection in children

verfasst von: Bénédicte Brichard, Dimitri Van der Linden

Erschienen in: European Journal of Pediatrics | Ausgabe 4/2009

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Abstract

Perinatal transmission remains the main cause of HIV infection in the pediatric population. Treatment of HIV-infected children has become less of a problem in resource-rich countries with a remarkable decrease of perinatal infections, resulting in an effective prevention of mother-to-child transmission and antiretroviral treatment of HIV infection in pediatrics because of differences in drug pharmacokinetics, the lack of available licensed drugs, the use of different immunologic markers and age-related adherence issues. This review, for the general pediatrician, summarizes the most recent pediatric data and guidelines for treatment of HIV. Recommendations for when to initiate therapy are more aggressive in children than in adults, particularly in infants because disease progression in children is more rapid. The indications to start therapy differ by age and are based on international immunologic and clinical classification system for HIV infection. At present, combination regimens of at least three drugs are recommended. Moreover, therapies must also consider the potential complications in these children currently treated for a long time.
Literatur
1.
Zurück zum Zitat Belzer ME, Fuchs DN, Luftman GS, Tucker DJ (1999) Antiretroviral adherence issues among HIV-positive adolescents and young adults. J Adolesc Health 25:316–319PubMedCrossRef Belzer ME, Fuchs DN, Luftman GS, Tucker DJ (1999) Antiretroviral adherence issues among HIV-positive adolescents and young adults. J Adolesc Health 25:316–319PubMedCrossRef
2.
Zurück zum Zitat Blanche S, Newell ML, Mayaux MJ et al (1997) Morbidity and mortality in European children vertically infected by HIV-1. The French Pediatric HIV Infection Study Group and European Collaborative Study. . J Acquir Immune Defic Syndr Hum Retrovirol 14:442–450PubMed Blanche S, Newell ML, Mayaux MJ et al (1997) Morbidity and mortality in European children vertically infected by HIV-1. The French Pediatric HIV Infection Study Group and European Collaborative Study. . J Acquir Immune Defic Syndr Hum Retrovirol 14:442–450PubMed
3.
Zurück zum Zitat Centers for Disease Control and Prevention (CDC) (2007) Revised recommendations for HIV testing of adults, adolescents and pregnant women in health-care settings. MMWR Recomm Rep 55:1–17 Centers for Disease Control and Prevention (CDC) (2007) Revised recommendations for HIV testing of adults, adolescents and pregnant women in health-care settings. MMWR Recomm Rep 55:1–17
4.
Zurück zum Zitat Centers for Disease Control and Prevention (1994) 994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age. MMWR Recomm Rep 43:1–10 Centers for Disease Control and Prevention (1994) 994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age. MMWR Recomm Rep 43:1–10
5.
Zurück zum Zitat Centers for Disease Control and Prevention (2001) Revised recommendations for HIV screening of pregnant women. MMWR Recomm Rep 50:63–85 Centers for Disease Control and Prevention (2001) Revised recommendations for HIV screening of pregnant women. MMWR Recomm Rep 50:63–85
6.
Zurück zum Zitat Chakraborty R (2005) HIV-1 infection in children: a clinical and immunologic overview. Curr HIV Res 3:31–41PubMedCrossRef Chakraborty R (2005) HIV-1 infection in children: a clinical and immunologic overview. Curr HIV Res 3:31–41PubMedCrossRef
7.
Zurück zum Zitat Cross Continents Collaboration for Kids (3Cs4kids) Analysis and Writing Committee (2008) Markers for predicting mortality in untreated HIV-infected children in resource-limited settings: a meta-analysis. AIDS 22:97–105 Cross Continents Collaboration for Kids (3Cs4kids) Analysis and Writing Committee (2008) Markers for predicting mortality in untreated HIV-infected children in resource-limited settings: a meta-analysis. AIDS 22:97–105
8.
Zurück zum Zitat Dao H, Mofenson LM, Ekpini R et al (2007) International recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update. Am J Obstet Gynecol 197:S42–S55PubMedCrossRef Dao H, Mofenson LM, Ekpini R et al (2007) International recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update. Am J Obstet Gynecol 197:S42–S55PubMedCrossRef
9.
Zurück zum Zitat Day E, Buckberry K, Sharland MR, Chakraborty R (2008) Novel treatment options for pediatric HIV infection. Curr Opin Investig Drugs 9:170–175PubMed Day E, Buckberry K, Sharland MR, Chakraborty R (2008) Novel treatment options for pediatric HIV infection. Curr Opin Investig Drugs 9:170–175PubMed
10.
Zurück zum Zitat Durant J, Clevenbergh P, Halfon P et al (1999) Drug-resistance genotyping in HIV-1 therapy: the VIRADAPT randomised controlled trial. Lancet 353:2195–2199PubMedCrossRef Durant J, Clevenbergh P, Halfon P et al (1999) Drug-resistance genotyping in HIV-1 therapy: the VIRADAPT randomised controlled trial. Lancet 353:2195–2199PubMedCrossRef
11.
Zurück zum Zitat Eley B (2008) Metabolic complications of antiretroviral therapy in HIV-infected children. Expert Opin Drug Metab Toxicol 4:37–49PubMedCrossRef Eley B (2008) Metabolic complications of antiretroviral therapy in HIV-infected children. Expert Opin Drug Metab Toxicol 4:37–49PubMedCrossRef
12.
Zurück zum Zitat Eley B, Nuttall J (2007) Antiretroviral therapy for children: challenges and opportunities. Ann Trop Paediatr 27:1–10PubMedCrossRef Eley B, Nuttall J (2007) Antiretroviral therapy for children: challenges and opportunities. Ann Trop Paediatr 27:1–10PubMedCrossRef
13.
Zurück zum Zitat European Paediatric Lipodystrophy Group (2004) Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV-infected children in Europe. AIDS 18:1443–1451CrossRef European Paediatric Lipodystrophy Group (2004) Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV-infected children in Europe. AIDS 18:1443–1451CrossRef
14.
Zurück zum Zitat Goetghebuer T, Haelterman E, Le Chenadec J et al (2008) Early vs deferred highly active antiretroviral therapy in HIV infected infants: a European Collaborative Cohort Study. Retrovirology 5(suppl 1):O25CrossRef Goetghebuer T, Haelterman E, Le Chenadec J et al (2008) Early vs deferred highly active antiretroviral therapy in HIV infected infants: a European Collaborative Cohort Study. Retrovirology 5(suppl 1):O25CrossRef
15.
Zurück zum Zitat Giaquinto C, Rampon O, Penazzato M et al (2007) Nucleoside and nucleotide reverse transcriptase inhibitors in children. Clin Drug Investig 27:509–531PubMedCrossRef Giaquinto C, Rampon O, Penazzato M et al (2007) Nucleoside and nucleotide reverse transcriptase inhibitors in children. Clin Drug Investig 27:509–531PubMedCrossRef
16.
Zurück zum Zitat Gray L, Newell ML, Thorne C et al (2001) Fluctuations in symptoms in human immunodeficiency virus-infected children: the first 10 years of life. Pediatrics 108:116–122PubMedCrossRef Gray L, Newell ML, Thorne C et al (2001) Fluctuations in symptoms in human immunodeficiency virus-infected children: the first 10 years of life. Pediatrics 108:116–122PubMedCrossRef
17.
Zurück zum Zitat Green H, Gibb DM, Walker AS, Paediatric European Network for the Treatment of AIDS (PENTA) et al (2007) Lamivudine/abacavir maintains virological superiority over zidovudine/lamivudine and zidovudine/abacavir beyond 5 years in children. AIDS 21:947–955PubMedCrossRef Green H, Gibb DM, Walker AS, Paediatric European Network for the Treatment of AIDS (PENTA) et al (2007) Lamivudine/abacavir maintains virological superiority over zidovudine/lamivudine and zidovudine/abacavir beyond 5 years in children. AIDS 21:947–955PubMedCrossRef
18.
Zurück zum Zitat HIV Paediatric Prognostic Markers Collaborative Study (2005) Use of total lymphocyte count for informing when to start antiretroviral therapy in HIV-infected children: a meta-analysis of longitudinal data. Lancet 366:1868–1874CrossRef HIV Paediatric Prognostic Markers Collaborative Study (2005) Use of total lymphocyte count for informing when to start antiretroviral therapy in HIV-infected children: a meta-analysis of longitudinal data. Lancet 366:1868–1874CrossRef
19.
Zurück zum Zitat Ikeda T, Ch’ng TW, Oleske JM (2007) Recommendations in pediatric antiretroviral therapy. Expert Opin Pharmacother 8:155–166PubMedCrossRef Ikeda T, Ch’ng TW, Oleske JM (2007) Recommendations in pediatric antiretroviral therapy. Expert Opin Pharmacother 8:155–166PubMedCrossRef
20.
Zurück zum Zitat Lujan-Zilbermann J, Rodriguez CA, Emmanuel PJ (2006) Pediatric HIV infection: diagnostic laboratory methods. Fetal Pediatr Pathol 25:249–260PubMedCrossRef Lujan-Zilbermann J, Rodriguez CA, Emmanuel PJ (2006) Pediatric HIV infection: diagnostic laboratory methods. Fetal Pediatr Pathol 25:249–260PubMedCrossRef
21.
Zurück zum Zitat Luzuriaga K, McManus M, Mofenson L, PACTG 356 Investigators et al (2004) A trial of three antiretroviral regimens in HIV-1 infected children. N Engl J Med 350:2471–2480PubMedCrossRef Luzuriaga K, McManus M, Mofenson L, PACTG 356 Investigators et al (2004) A trial of three antiretroviral regimens in HIV-1 infected children. N Engl J Med 350:2471–2480PubMedCrossRef
22.
Zurück zum Zitat McKellar MS, Callens SF, Colebunders R (2008) Pediatric HIV infection: the state of antiretroviral therapy. Expert Rev Anti Infect Ther 6:167–180PubMedCrossRef McKellar MS, Callens SF, Colebunders R (2008) Pediatric HIV infection: the state of antiretroviral therapy. Expert Rev Anti Infect Ther 6:167–180PubMedCrossRef
23.
Zurück zum Zitat Prendergast A, Tudor-Williams G, Jeena P et al (2007) International perspectives, progress and future challenges of paediatric HIV infection. Lancet 370:68–80PubMedCrossRef Prendergast A, Tudor-Williams G, Jeena P et al (2007) International perspectives, progress and future challenges of paediatric HIV infection. Lancet 370:68–80PubMedCrossRef
24.
Zurück zum Zitat Resino S, Resino R, Micheloud D, Spanish Group of Paediatric HIV infection et al (2006) Long-term effects of highly active antiretroviral therapy in pretreated, vertically HIV type 1-infected children: 6 years of follow-up. Clin Infect Dis 42:862–869PubMedCrossRef Resino S, Resino R, Micheloud D, Spanish Group of Paediatric HIV infection et al (2006) Long-term effects of highly active antiretroviral therapy in pretreated, vertically HIV type 1-infected children: 6 years of follow-up. Clin Infect Dis 42:862–869PubMedCrossRef
25.
Zurück zum Zitat Starr SE, Fletcher CV, Spector SA, PACTG 382 Study Team. Pediatric AIDS Clinical Trials Group et al (2002) Efavirenz liquid formulation in human immunodeficiency virus-infected children. Pediatr Infect Dis J 21:659–663PubMedCrossRef Starr SE, Fletcher CV, Spector SA, PACTG 382 Study Team. Pediatric AIDS Clinical Trials Group et al (2002) Efavirenz liquid formulation in human immunodeficiency virus-infected children. Pediatr Infect Dis J 21:659–663PubMedCrossRef
26.
Zurück zum Zitat Van der Linden D, Hainaut M, Goetghebuer T et al (2007) Effectiveness of early initiation of protease inhibitor-sparing antiretroviral regimen in human immunodeficiency virus-1 vertically infected infants. Pediatr Infect Dis J 26:359–361PubMedCrossRef Van der Linden D, Hainaut M, Goetghebuer T et al (2007) Effectiveness of early initiation of protease inhibitor-sparing antiretroviral regimen in human immunodeficiency virus-1 vertically infected infants. Pediatr Infect Dis J 26:359–361PubMedCrossRef
27.
Zurück zum Zitat Violari A, Cotton MF, Gibb DM et al (2008) Early antiretroviral therapy and mortality among HIV-infected infants. The CHER Study Team N Engl J Med 359:2233–2244PubMedCrossRef Violari A, Cotton MF, Gibb DM et al (2008) Early antiretroviral therapy and mortality among HIV-infected infants. The CHER Study Team N Engl J Med 359:2233–2244PubMedCrossRef
28.
Zurück zum Zitat Working Group on Antiretroviral Therapy and Medical Management of HIV-infected children (2008) Guidelines for the use of antiretroviral gents in pediatric HIV infection and pediatric antiretroviral drug information. http://AIDSinfo.nih.gov Working Group on Antiretroviral Therapy and Medical Management of HIV-infected children (2008) Guidelines for the use of antiretroviral gents in pediatric HIV infection and pediatric antiretroviral drug information. http://​AIDSinfo.​nih.​gov
Metadaten
Titel
Clinical practice treatment of HIV infection in children
verfasst von
Bénédicte Brichard
Dimitri Van der Linden
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
European Journal of Pediatrics / Ausgabe 4/2009
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-008-0914-8

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