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Oral Combinational Antiretroviral Treatment in HIV-1 Infected Humanized Mice
Published on: October 6, 2022
[New challenges in therapeutic management of human immunodeficiency virus-infected children]
1Service de pédiatrie générale de l'hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. albert.faye@rdb.ap-hop-paris.fr
Insights
Antiretroviral therapies have significantly reduced HIV/AIDS deaths in children. Optimizing drug delivery and ensuring global access remain key challenges for effective pediatric HIV management.
Area of Science:
- Pediatric infectious diseases
- Clinical pharmacology
- Public health
Context:
- Over 2 million children globally are infected with the human immunodeficiency virus (HIV).
- Antiretroviral multitherapies have markedly reduced HIV-related mortality and morbidity in children.
- Therapeutic management is complex, influenced by socio-familial factors and drug toxicities.
Purpose:
- To review the current landscape of pediatric HIV management.
- To identify challenges in achieving optimal therapeutic outcomes in HIV-infected children.
- To highlight areas for future research and intervention.
Summary:
- Advances in antiretroviral multitherapies have improved clinical and immunological outcomes in children with HIV.
- Virological failure can occur due to pediatric pharmacokinetic specificities and suboptimal drug formulations.
- More potent drugs and adapted presentations are reducing the risk of virological failure.
- Prospective studies and pediatric drug evaluations are crucial for advancing treatment.
Impact:
- Improved therapeutic strategies can enhance the quality of life for HIV-infected children.
- Addressing pharmacokinetic challenges and drug delivery is vital for preventing treatment failure.
- Universal access to pediatric antiretroviral drugs, especially in developing nations, is a critical global health priority.
Abstract:
More than 2 millions of children worldwide are HIV-infected. Recently, the HIV related mortality and morbidity has dramatically decreased due to the use of antiretroviral multitherapies in the HIV-infected children. However the therapeutic management of HIV-infected children is complex and may be complicated by socio-familial issues. Short and long term toxicity of antiretrovirals but also of HIV itself are of concern. Despite the good clinical and immunological results of antiretroviral multitherapies, virological failure may occur. Paediatric pharmacokinetic specificities and inadequate galenic presentation of drugs could lead to virological failure. However, the use of more potent drugs with more adapted presentation actually reduces this risk of failure. Prospective cohorts of HIV-infected children and new antiretroviral drugs paediatric evaluation are of key importance and can improve the paediatric therapeutic management. Finally, universal access to antiretroviral drugs in children, particularly in developing countries is the major actual and future challenge.
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