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Human immunodeficiency virus type 1 phenotypes in children with advanced disease treated with long-term zalcitabine

R M Viani1, I L Smith, S A Spector

  • 1Department of Pediatrics, University of California at San Diego, La Jolla 92093-0672, USA.

The Journal of Infectious Diseases
|March 14, 1998
PubMed

Insights

Zalcitabine monotherapy in HIV-1 infected children showed a low incidence of drug resistance. Some patients experienced a switch from syncytium-inducing (SI) to non-SI (NSI) HIV-1 phenotypes during treatment.

Area of Science:

  • Virology
  • Pediatric Infectious Diseases
  • Antiretroviral Therapy

Background:

  • Human immunodeficiency virus type 1 (HIV-1) infection in children requires effective antiretroviral strategies.
  • Zidovudine-experienced children were enrolled in a trial evaluating zalcitabine monotherapy.
  • Understanding viral phenotype and resistance is crucial for treatment selection.

Purpose of the Study:

  • To assess the syncytium-inducing (SI) phenotype and zalcitabine resistance in HIV-1 isolates from children.
  • To evaluate changes in viral phenotype during zalcitabine monotherapy.
  • To inform combination antiretroviral drug selection.

Main Methods:

  • Prospective trial of zalcitabine (dideoxycytidine) monotherapy in 38 HIV-1 infected children.
  • Analysis of baseline and posttreatment HIV-1 isolates for SI/NSI phenotype.
  • In vitro drug susceptibility assays to determine zalcitabine resistance.

Main Results:

  • Twenty baseline isolates were SI, and 18 were NSI.
  • Phenotype stability was observed in most patients (>44 weeks of treatment).
  • Low incidence of zalcitabine resistance (3%) and some SI-to-NSI phenotype reversion (20%) were noted.

Conclusions:

  • Zalcitabine monotherapy demonstrates a low rate of resistance development in this pediatric cohort.
  • A significant proportion of patients showed a switch from SI to NSI HIV-1 phenotype.
  • These findings are valuable for guiding future antiretroviral treatment choices in children.

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