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Efficacy and plasma concentrations of indinavir when boosted with ritonavir in human immunodeficiency virus-infected

Nottasorn Plipat1, Tim R Cressey, Nirun Vanprapar

  • 1Division of Pediatric Infectious Diseases, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand. nplipat@msn.com

The Pediatric Infectious Disease Journal
|January 2, 2007
PubMed

Insights

Lower doses of indinavir (IDV) with ritonavir (RTV) boost are effective and safe in children. This study shows good virologic response with reduced IDV dosages, offering a viable treatment option.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • HIV/AIDS Treatment

Background:

  • HIV infection remains a significant concern in pediatric populations.
  • Optimizing antiretroviral therapy (ART) regimens is crucial for long-term management and adherence in children.
  • Previous studies have explored various dosing strategies for protease inhibitors like indinavir (IDV).

Purpose of the Study:

  • To evaluate the efficacy and safety of reduced-dose indinavir (IDV) when boosted with ritonavir (RTV) in pediatric patients.
  • To determine plasma concentrations of IDV and RTV at specific time points.
  • To assess virologic response in children receiving this optimized ART regimen.

Main Methods:

  • A cohort of 19 children receiving indinavir (IDV) was evaluated.
  • Two groups received IDV: one with a 100 mg ritonavir (RTV) boost (n=12), and another with full-dose RTV (n=7).
  • Indinavir trough concentrations (Ctrough) and C2hours were measured, alongside virologic response assessment.

Main Results:

  • Geometric mean (GM) of IDV Ctrough was 0.17 mg/L (90% CI: 0.06-0.50) for children on IDV with 100 mg RTV.
  • GM of IDV Ctrough was 0.40 mg/L (90% CI: 0.10-1.61) for children on IDV with full-dose RTV.
  • Eighteen out of 19 children achieved a good virologic response, indicating treatment effectiveness.

Conclusions:

  • Reduced dosages of indinavir (IDV) when boosted with ritonavir (RTV) achieve efficacious plasma concentrations in children.
  • This optimized dosing strategy can be safely utilized in pediatric HIV treatment.
  • The findings support the use of lower IDV doses with RTV for effective pediatric antiretroviral therapy.

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