Antiretroviral therapy for children.
Advances in the development of antiviral drugs have been rapid and dramatic. Since the recognition of HIV-1 as the cause of AIDS in 1984, and improved understanding of retroviral replication and pathogenesis, three antiviral drugs, Zidovudine, Didanosine, and Zalcitabine, have been developed to the point of routine use in humans. There is substantial experience with the former two in children. Despite being unable to cure HIV-1 infection, the benefits of antiretroviral therapy, including extended survival and reductions in opportunistic infections in adults, and improved weight gain and well-being in children, are strong arguments for routine treatment of symptomatic disease. Because these agents may also interfere with human cellular processes and have toxicities including anemia, neutropenia, pancreatitis, and neuropathy, their routine use for the treatment of asymptomatic children requires further controlled study. There are multiple candidate agents being developed for entry into clinical trials. An additional potentially effective strategy is the use of combinations of drugs at the same time or in sequence to maximize the viral targets being attacked, while minimizing toxicity, and to prevent the emergence of a drug-resistant virus.
Department of Pediatrics, New York University Medical Center, New York.
K
K
Krasinski
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000328:Adult; D002648:Child; D002986:Clinical Trials as Topic; D018849:Controlled Clinical Trials as Topic; D004279:DNA, Viral / Q000032:analysis; D016049:Didanosine / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular; D014779:Virus Replication; D016047:Zalcitabine / Q000627:therapeutic use*; D015215:Zidovudine / Q000627:therapeutic use*
D004279:DNA, Viral; D015215:Zidovudine; D016047:Zalcitabine; D016049:Didanosine