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Special considerations concerning the use of antiretroviral drugs in children

Pierre Frange1,2,3, Naïm Bouazza4,5, Patricia Fassinou6

  • 1a Microbiology Laboratory , Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris , France.

Expert Review of Anti-Infective Therapy
|September 21, 2016
PubMed

Insights

All children with human immunodeficiency virus (HIV) should receive antiretroviral therapy, as it is highly effective and safe. Early treatment, starting soon after birth, offers the best chance for long-term immune control.

Area of Science:

  • Pediatric infectious diseases
  • Clinical pharmacology
  • Immunology

Background:

  • Antiretroviral therapy (ART) is highly effective for HIV in children and adults.
  • Treatment guidelines now recommend ART for nearly all HIV-infected children.
  • Pediatric ART use often relies on adult data due to study challenges.

Purpose of the Study:

  • To review the current understanding of antiretroviral therapy in children.
  • To highlight the importance of early treatment initiation for long-term outcomes.
  • To advocate for improved pediatric formulations and research.

Main Methods:

  • Review of existing literature and clinical experience in pediatric HIV treatment.
  • Extrapolation of data from adult antiretroviral therapy studies.
  • Analysis of pharmacokinetic and toxicity data for pediatric populations.

Main Results:

  • Latest generation antiretroviral drugs show no major irreversible toxicity in children.
  • Early ART initiation, shortly after birth, appears to improve long-term immunological control.
  • Despite formulation challenges, pediatric ART is manageable.

Conclusions:

  • All HIV-infected children should be treated with antiretroviral drugs.
  • Manufacturers should develop age-appropriate formulations and support pediatric studies.
  • Very early treatment is crucial for maximizing long-term immune control in children.
Abstract

Keywords:
HIVantiretroviral therapychildrenpharmacologytolerance

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