Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children

Beatriz Larru Martinez1, F Andrew I Riordan21Laboratorio Inmuno-Biolog&iacute;a Molecular, Hospital General Universitario Gregorio Mara&ntilde;&oacute;n, Madrid, Spain; 2Department of Infectious Diseases, Alder Hey Children&rsquo;s NHS Foundation Trust, Liverpool, UKA...

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Autores principales:	Beatriz Larru Martinez, F Andrew I Riordan
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/ada36799a34b4b4cb299ebd5317f7b04
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spelling	oai:doaj.org-article:ada36799a34b4b4cb299ebd5317f7b042021-12-02T06:45:24ZNovel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children1179-1373https://doaj.org/article/ada36799a34b4b4cb299ebd5317f7b042010-03-01T00:00:00Zhttp://www.dovepress.com/novel-strategies-in-the-use-of-lopinavirritonavir-for-the-treatment-of-a4148https://doaj.org/toc/1179-1373Beatriz Larru Martinez1, F Andrew I Riordan21Laboratorio Inmuno-Biolog&iacute;a Molecular, Hospital General Universitario Gregorio Mara&ntilde;&oacute;n, Madrid, Spain; 2Department of Infectious Diseases, Alder Hey Children&rsquo;s NHS Foundation Trust, Liverpool, UKAbstract: Lopinavir/ritonavir (LPV/r) is considered by many as the first choice protease inhibitor (PI) for children. This co-formulation avoids the need for children to take ritonavir separately to &ldquo;boost&rdquo; the levels of lopinavir. LPV/r has high virologic potency, an excellent toxicity profile and a high barrier to the development of viral resistance. However, LPV/r has poor tolerability of the oral suspension (due to the poor taste of ritonavir), difficult dosing requirements and metabolic side effects, especially hyperlipidemia. The new tablet low-dose formulation (100/25 mg) may allow more convenient antiretroviral treatment in children. Novel strategies of LPV/r in childhood could maximize its advantages. For example, infants infected with HIV despite single dose Nevirapine after birth need effective combination antiretroviral treatment. This can be given using a higher dose of LPV/r with therapeutic drug monitoring. Other novel uses include once daily LPV/r regimens in older children and adolescents and lower doses of LPV/r in certain populations, which may decrease hyperlipidemia. Heavily pre-treated children might benefit from a double PI/r regimen which includes LPV/r. The high potency of LPV/r needs to be balanced with convenient regimens, to enhance adherence and decrease toxicity whenever possible. The aim of this review is to discuss the rationale behind these novel strategies of LPV/r use in pediatric antiretroviral treatment as well as their results and limitations.Keywords: human immunodeficiency virus, children, antiretroviral therapy, lopinavir, ritonavir Beatriz Larru MartinezF Andrew I RiordanDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2010, Iss default, Pp 59-67 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Beatriz Larru Martinez F Andrew I Riordan Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
description	Beatriz Larru Martinez1, F Andrew I Riordan21Laboratorio Inmuno-Biolog&iacute;a Molecular, Hospital General Universitario Gregorio Mara&ntilde;&oacute;n, Madrid, Spain; 2Department of Infectious Diseases, Alder Hey Children&rsquo;s NHS Foundation Trust, Liverpool, UKAbstract: Lopinavir/ritonavir (LPV/r) is considered by many as the first choice protease inhibitor (PI) for children. This co-formulation avoids the need for children to take ritonavir separately to &ldquo;boost&rdquo; the levels of lopinavir. LPV/r has high virologic potency, an excellent toxicity profile and a high barrier to the development of viral resistance. However, LPV/r has poor tolerability of the oral suspension (due to the poor taste of ritonavir), difficult dosing requirements and metabolic side effects, especially hyperlipidemia. The new tablet low-dose formulation (100/25 mg) may allow more convenient antiretroviral treatment in children. Novel strategies of LPV/r in childhood could maximize its advantages. For example, infants infected with HIV despite single dose Nevirapine after birth need effective combination antiretroviral treatment. This can be given using a higher dose of LPV/r with therapeutic drug monitoring. Other novel uses include once daily LPV/r regimens in older children and adolescents and lower doses of LPV/r in certain populations, which may decrease hyperlipidemia. Heavily pre-treated children might benefit from a double PI/r regimen which includes LPV/r. The high potency of LPV/r needs to be balanced with convenient regimens, to enhance adherence and decrease toxicity whenever possible. The aim of this review is to discuss the rationale behind these novel strategies of LPV/r use in pediatric antiretroviral treatment as well as their results and limitations.Keywords: human immunodeficiency virus, children, antiretroviral therapy, lopinavir, ritonavir
format	article
author	Beatriz Larru Martinez F Andrew I Riordan
author_facet	Beatriz Larru Martinez F Andrew I Riordan
author_sort	Beatriz Larru Martinez
title	Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
title_short	Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
title_full	Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
title_fullStr	Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
title_full_unstemmed	Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children
title_sort	novel strategies in the use of lopinavir/ritonavir for the treatment of hiv infection in children
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/ada36799a34b4b4cb299ebd5317f7b04
work_keys_str_mv	AT beatrizlarrumartinez novelstrategiesintheuseoflopinavirritonavirforthetreatmentofhivinfectioninchildren AT fandrewiriordan novelstrategiesintheuseoflopinavirritonavirforthetreatmentofhivinfectioninchildren
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Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children

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