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Adverse effects of antiretroviral therapy in HIV-1 infected children

Ira Shah1

  • 1Department of Pediatric HIV Clinic, B. J. Wadia Hospital for Children, Parel, Mumbai, India. irashah@pediatriconcall.com

Journal of Tropical Pediatrics
|August 30, 2005
PubMed

Insights

Adverse effects from antiretroviral therapy (ART) are common in children with HIV-1. Hepatotoxicity, elevated serum amylase, and zidovudine-induced anemia were the most frequent, often reversible with dose adjustments.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Pharmacology
  • HIV/AIDS Research

Background:

  • Antiretroviral therapy (ART) is crucial for managing HIV-1 infection in children.
  • Understanding the adverse effects of ART is essential for optimizing treatment and patient outcomes.
  • Pediatric populations may experience unique adverse events or different frequencies compared to adults.

Purpose of the Study:

  • To prospectively identify and characterize adverse effects associated with ART in HIV-1 infected children.
  • To determine factors, including viral load, associated with the occurrence of these adverse effects.
  • To evaluate the reversibility and management strategies for ART-related adverse events in pediatric patients.

Main Methods:

  • Prospective study conducted in a pediatric and perinatal HIV clinic.
  • Involved 43 HIV-1 positive children aged 5 months to 14 years initiating ART.
  • Adverse effects were monitored, documented, and analyzed in relation to viral load and treatment duration.

Main Results:

  • 30% of children experienced ART-related adverse effects.
  • Hepatotoxicity (16%), elevated serum amylase (12%), and zidovudine (AZT)-induced anemia (12%) were most common.
  • Hepatotoxicity occurred at higher viral loads (mean 118,608 copies/ml) than elevated serum amylase (mean 37,631 copies/ml).
  • Most adverse effects, including hepatotoxicity and AZT-induced anemia, were reversible with dose modification or drug omission.

Conclusions:

  • Adverse effects are a significant concern in children receiving ART for HIV-1.
  • Hepatotoxicity and hematologic abnormalities are common and require careful monitoring.
  • Early identification and management, including dose adjustments or drug substitution, can effectively mitigate most adverse events.

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