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Efficacy and tolerability of nevirapine- versus efavirenz-containing regimens in HIV-infected Thai children.
Int J Infect Dis. 2008 Nov; 12(6):e33-8.IJ

Abstract

BACKGROUND

Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based highly active antiretroviral therapy (HAART) has been the most affordable regimen for the HIV-infected in developing countries. There are limited data comparing nevirapine (NVP) to efavirenz (EFV) in HIV-infected children. This study aimed to assess the efficacy and tolerability of NVP-based regimens compared to EFV-based regimens in HIV-infected children in Thailand.

METHODS

The medical records of HIV-infected children who had received NNRTI-based regimens for more than 6 months at the Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand, were reviewed.

RESULTS

Of the 139 HIV-infected children studied, 70 were male, and the median age at treatment initiation was 6.08 years (range 0.32-14.56 years); the median duration of follow-up was 36 months (range 6-66 months). The median baseline CD4 cell count was 185cells/mm(3) (range 2-3482cells/mm(3)) and the median baseline CD4 percentage was 7.20% (range 0.11-36.57%). An NVP-based regimen was initiated in 61 (44%): 38 antiretroviral (ARV)-naïve and 23 ARV-experienced. An EFV-based regimen was initiated in 78 (56%): 34 ARV-naïve and 44 ARV-experienced. The CD4 cell count and percentage gains were not different between the NVP and EFV groups in both the ARV-naïve and the ARV-experienced. However, ARV-naïve children who received an EFV regimen had significantly lower baseline CD4 levels than those who received an NVP regimen. ARV-naïve children had a better CD4 response than the ARV-experienced. The survival rates of children in the NVP groups were not different from those in the EFV groups for both the ARV-naïve and the ARV-experienced. Treatment failure occurred in one ARV-naïve NVP case (2.6%), two ARV-naïve EFV cases (5.8%), and nine ARV-experienced NVP cases (39%) at 24 months of treatment, and 11 ARV-experienced EFV cases (25%) at 18 months of treatment. Seven (10%) children had adverse effects from treatment with NVP. The main side effects were rash and hepatitis; six had to switch to EFV. Four (5%) children had adverse effects from treatment with EFV; two had to switch to NVP.

CONCLUSIONS

Both NVP- and EFV-based HAART regimens were effective in children in Thailand for at least 3 years. HIV-infected Thai children generally tolerated NNRTI well.

Authors+Show Affiliations

Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

18573672

Citation

Lapphra, Keswadee, et al. "Efficacy and Tolerability of Nevirapine- Versus Efavirenz-containing Regimens in HIV-infected Thai Children." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 12, no. 6, 2008, pp. e33-8.
Lapphra K, Vanprapar N, Chearskul S, et al. Efficacy and tolerability of nevirapine- versus efavirenz-containing regimens in HIV-infected Thai children. Int J Infect Dis. 2008;12(6):e33-8.
Lapphra, K., Vanprapar, N., Chearskul, S., Phongsamart, W., Chearskul, P., Prasitsuebsai, W., & Chokephaibulkit, K. (2008). Efficacy and tolerability of nevirapine- versus efavirenz-containing regimens in HIV-infected Thai children. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 12(6), e33-8. https://doi.org/10.1016/j.ijid.2007.10.008
Lapphra K, et al. Efficacy and Tolerability of Nevirapine- Versus Efavirenz-containing Regimens in HIV-infected Thai Children. Int J Infect Dis. 2008;12(6):e33-8. PubMed PMID: 18573672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and tolerability of nevirapine- versus efavirenz-containing regimens in HIV-infected Thai children. AU - Lapphra,Keswadee, AU - Vanprapar,Nirun, AU - Chearskul,Sanay, AU - Phongsamart,Wanatpreeya, AU - Chearskul,Pimpanada, AU - Prasitsuebsai,Wasana, AU - Chokephaibulkit,Kulkanya, Y1 - 2008/06/24/ PY - 2006/12/21/received PY - 2007/10/25/revised PY - 2007/10/30/accepted PY - 2008/6/25/pubmed PY - 2009/1/28/medline PY - 2008/6/25/entrez SP - e33 EP - 8 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 12 IS - 6 N2 - BACKGROUND: Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based highly active antiretroviral therapy (HAART) has been the most affordable regimen for the HIV-infected in developing countries. There are limited data comparing nevirapine (NVP) to efavirenz (EFV) in HIV-infected children. This study aimed to assess the efficacy and tolerability of NVP-based regimens compared to EFV-based regimens in HIV-infected children in Thailand. METHODS: The medical records of HIV-infected children who had received NNRTI-based regimens for more than 6 months at the Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand, were reviewed. RESULTS: Of the 139 HIV-infected children studied, 70 were male, and the median age at treatment initiation was 6.08 years (range 0.32-14.56 years); the median duration of follow-up was 36 months (range 6-66 months). The median baseline CD4 cell count was 185cells/mm(3) (range 2-3482cells/mm(3)) and the median baseline CD4 percentage was 7.20% (range 0.11-36.57%). An NVP-based regimen was initiated in 61 (44%): 38 antiretroviral (ARV)-naïve and 23 ARV-experienced. An EFV-based regimen was initiated in 78 (56%): 34 ARV-naïve and 44 ARV-experienced. The CD4 cell count and percentage gains were not different between the NVP and EFV groups in both the ARV-naïve and the ARV-experienced. However, ARV-naïve children who received an EFV regimen had significantly lower baseline CD4 levels than those who received an NVP regimen. ARV-naïve children had a better CD4 response than the ARV-experienced. The survival rates of children in the NVP groups were not different from those in the EFV groups for both the ARV-naïve and the ARV-experienced. Treatment failure occurred in one ARV-naïve NVP case (2.6%), two ARV-naïve EFV cases (5.8%), and nine ARV-experienced NVP cases (39%) at 24 months of treatment, and 11 ARV-experienced EFV cases (25%) at 18 months of treatment. Seven (10%) children had adverse effects from treatment with NVP. The main side effects were rash and hepatitis; six had to switch to EFV. Four (5%) children had adverse effects from treatment with EFV; two had to switch to NVP. CONCLUSIONS: Both NVP- and EFV-based HAART regimens were effective in children in Thailand for at least 3 years. HIV-infected Thai children generally tolerated NNRTI well. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/18573672/Efficacy_and_tolerability_of_nevirapine__versus_efavirenz_containing_regimens_in_HIV_infected_Thai_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(08)00102-1 DB - PRIME DP - Unbound Medicine ER -