Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children

Objective: The use of antiretroviral therapy in HlV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcrip...

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Autores principales:	ROMANELLI,ROBERTA M. C, PINTO,JORGE A, MELO,LAURA J, VASCONCELOS,MARIANA A, MATOS PEREIRA,RAFAEL DE
Lenguaje:	English
Publicado:	Sociedad Chilena de Pediatría 2008
Materias:	Acquired immunodeficiency syndrome anti-HIV drugs therapy
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062008000500016
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spelling	oai:scielo:S0370-410620080005000162009-03-04Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected childrenROMANELLI,ROBERTA M. CPINTO,JORGE AMELO,LAURA JVASCONCELOS,MARIANA AMATOS PEREIRA,RAFAEL DE Acquired immunodeficiency syndrome anti-HIV drugs therapy Objective: The use of antiretroviral therapy in HlV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HlV-infected children. Methods: The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Mnas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis. Results: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). Conclusión: Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HlV-infected children. Therefore, triple therapy should be the treatment of choice.info:eu-repo/semantics/openAccessSociedad Chilena de PediatríaRevista chilena de pediatría v.79 n.5 20082008-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062008000500016en10.4067/S0370-41062008000500016
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Acquired immunodeficiency syndrome anti-HIV drugs therapy
spellingShingle	Acquired immunodeficiency syndrome anti-HIV drugs therapy ROMANELLI,ROBERTA M. C PINTO,JORGE A MELO,LAURA J VASCONCELOS,MARIANA A MATOS PEREIRA,RAFAEL DE Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
description	Objective: The use of antiretroviral therapy in HlV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HlV-infected children. Methods: The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Mnas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis. Results: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). Conclusión: Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HlV-infected children. Therefore, triple therapy should be the treatment of choice.
author	ROMANELLI,ROBERTA M. C PINTO,JORGE A MELO,LAURA J VASCONCELOS,MARIANA A MATOS PEREIRA,RAFAEL DE
author_facet	ROMANELLI,ROBERTA M. C PINTO,JORGE A MELO,LAURA J VASCONCELOS,MARIANA A MATOS PEREIRA,RAFAEL DE
author_sort	ROMANELLI,ROBERTA M. C
title	Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
title_short	Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
title_full	Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
title_fullStr	Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
title_full_unstemmed	Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children
title_sort	effectiveness of dual and triple antiretroviral therapy in the treatment of hlv-infected children
publisher	Sociedad Chilena de Pediatría
publishDate	2008
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062008000500016
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Effectiveness of dual and triple antiretroviral therapy in the treatment of HlV-infected children

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