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Drug therapy
Long-term safety and effectiveness of lopinavir/ritonavir in antiretroviral-experienced HIV-1-infected children
  1. Christoph Rudin1,
  2. Marcel Wolbers2,
  3. David Nadal3,
  4. Martin Rickenbach4,
  5. Heiner C Bucher2,
  6. the Pediatric Infectious Disease Group of Switzerland (PIGS) and the Swiss Mother and Child HIV Cohort Study (MoCHiV)
  1. 1Division of Infectious Diseases, University Children's Hospital, Basel, Switzerland
  2. 2Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital, Basel, Switzerland
  3. 3Division of Infectious Diseases, University Children's Hospital, Zurich, Switzerland
  4. 4Coordination and Data Center, Swiss HIV Cohort Study, Lausanne, Switzerland
  1. Correspondence to Professor Christoph Rudin, Division of Infectious Diseases, University Children's Hospital UKBB, Roemergasse, 8, Basel CH4058, Switzerland; christoph.rudin{at}unibas.ch

Abstract

Aim To evaluate the long-term safety and effectiveness of lopinavir/ritonavir (LPV/r) in a population-based cohort of HIV-1-infected children.

Methods All children enrolled in the Swiss Mother and Child HIV Cohort Study, treated with LPV/r-based combination antiretroviral treatment (cART) between November 2000 and October 2008, were included.

Results 88 children (25 (28%) protease inhibitor (PI)-naive, 16 (18%) ART-naive) were analysed (251 patient-years on LPV/r). After 48 weeks on LPV/r, 70 children had a median (interquartile range (IQR)) decrease in HIV-1 viral load of 4.25 log (5.45–3.17; PI-naive, n=17) and 2.53 (3.68–1.38; PI-experienced, n=53). Median (IQR) increase in CD4 count was 429 (203–593; PI-naive) and 177 (21–331; PI-experienced) cells/µl. These effects remained stablethroughout 192 weeks for 25 children. Treatment was stopped for viral rebound in seven and suspected toxicity in 12 children.

Conclusion Long-term treatment with LPV/r-based cART is safe and effective in HIV-1-infected children.

https://doi.org/10.1136/adc.2009.169375

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    Footnotes

    • The Pediatric Infectious Disease Group of Switzerland (PIGS) C Aebi, W Bär, Ch Berger (chair), F Besson, U Bühlmann, J-J Cheseaux, D Desgrandchamps, A Diana, A Duppenthaler, A Gervaix, H P Gnehm, U Heininger, U A Hunziker, C Kahlert, C Kind, H Kuchler, A Loher, V Masserey-Spicher, C Myers, D Nadal, C Posfay-Barbe, C Rudin, U B Schaad, C-A Siegrist, J Stähelin, B Vaudaux, C-A Wyler-Lazarevic, W Zingg.

    • The Swiss Mother and Child HIV Cohort Study (MoCHiV) C Aebi, M Battegay, E Bernasconi, J Böni, P Brazzola, H C Bucher, Ph Bürgisser, A Calmy, S Cattacin, M Cavassini, J-J Cheseaux, G Drack, R Dubs, M Egger, L Elzi, M Fischer, M Flepp, A Fontana, P Francioli (President of the SHCS, Centre Hospitalier Universitaire Vaudois, CH-1011, Lausanne), H J Furrer, C Fux, A Gayet-Ageron, S Gerber, M Gorgievski, H Günthard, Th Gyr, H Hirsch, B Hirschel, I Hösli, M Hüsler, L Kaiser, Ch Kahlert, U Karrer, C Kind, Th Klimkait, B Ledergerber, G Martinetti, B Martinez, N Müller, D Nadal, F Paccaud, G Pantaleo, L Raio, A Rauch, S Regenass, M Rickenbach, C Rudin (Chairman of the MoCHiV Substudy, Basel UKBB, Römergasse 8, CH-4058 Basel), P Schmid, D Schultze, J Schüpbach, R Speck, P Taffé, A Telenti, A Trkola, P Vernazza, R Weber, C-A Wyler, S Yerly.

    • Funding MW and HCB are supported by grants from Santésuisse and the Gottfried and Julia Bangerter-Rhyner-Foundation. This study has been financed in the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (Grant no 3347–069366). Abbott Laboratories (Abbott Park, Illinois, USA) and Abbott AG (Baar, Switzerland) also provided financial support for this study.

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the from the cantonal ethics committees of all involved treatment centres.

    • Provenance and peer review Not commissioned; externally peer reviewed.