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Switch from ritonavir to indinavir in combination therapy for HIV-1-infected children

Stephen I Pelton1, Kenneth Stanley, Ram Yogev

  • 1Boston Medical Center, Boston, MA 02118, USA. spelton@bu.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 26, 2005
PubMed

Insights

Switching from ritonavir to indinavir in combination antiretroviral therapy for children with HIV-1 was a viable strategy. This change maintained viral load control and CD4 cell counts without significant pharmacokinetic alterations.

Area of Science:

  • Pediatric infectious diseases
  • Antiretroviral therapy
  • HIV-1 management

Background:

  • Protease inhibitors are crucial in combination antiretroviral treatment for children with HIV-1.
  • Alternative therapeutic strategies are sometimes needed due to tolerance or toxicity issues with protease inhibitors.

Purpose of the Study:

  • To evaluate the efficacy and safety of switching from ritonavir to indinavir in pediatric HIV-1 treatment.
  • To compare outcomes between children switched to indinavir and those continuing ritonavir.

Main Methods:

  • A randomized clinical trial involving HIV-1 infected children aged 2-17 years.
  • A switch from ritonavir capsules to indinavir capsules for 25 children when ritonavir became unavailable.
  • A matched-pairs analysis comparing the indinavir group with a ritonavir group.

Main Results:

  • No significant differences in HIV-1 RNA load (
  • No significant differences in median CD4 cell counts over time between the groups.
  • Observed toxicities with indinavir were consistent with known side effects; no significant pharmacokinetic interactions were noted.

Conclusions:

  • Switching from ritonavir to indinavir is a practical therapeutic strategy in pediatric HIV-1 combination antiretroviral treatment.
  • This switch effectively maintained viral suppression and immunological status.
Abstract

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