Combination treatment with zidovudine, didanosine, and nevirapine in infants with human immunodeficiency virus type 1 infection.
BACKGROUND
In infants and children with maternally acquired human immunodeficiency virus type 1 (HIV-1) infection, treatment with a single antiretroviral agent has limited efficacy. We evaluated the safety and efficacy of a three-drug regimen in a small group of maternally infected infants.


METHODS
Zidovudine, didanosine, and nevirapine were administered in combination orally to eight infants 2 to 16 months of age. The efficacy of antiretroviral treatment was evaluated by serial measurements of plasma HIV-1 RNA, quantitative plasma cultures, and quantitative cultures of peripheral-blood mononuclear cells.


RESULTS
The three-drug regimen was well tolerated, without clinically important adverse events. Within four weeks, there were reductions in plasma levels of HIV-1 RNA of at least 96 percent (1.5 log) in seven of the eight study patients. Over the 6-month study period, replication of HIV-1 was controlled in two infants who began therapy at 2 1/2 months of age. Plasma RNA levels were reduced by 0.5 to 1.5 log in five of the other six infants.


CONCLUSIONS
Although further observations are needed, it appears that in infants with maternally acquired HIV-1 infection, combined treatment with zidovudine, didanosine, and nevirapine is well tolerated and has sustained efficacy against HIV-1.
Luzuriaga
K
K
Department of Pediatrics, University of Massachusetts Medical School, Worcester 01605, USA.
Bryson
Y
Y
Krogstad
P
P
Robinson
J
J
Stechenberg
B
B
Lamson
M
M
Cort
S
S
Sullivan
J L
JL
D000284:Administration, Oral; D019380:Anti-HIV Agents / Q000097:blood / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000187:drug effects; D016049:Didanosine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D019829:Nevirapine; D011725:Pyridines / Q000097:blood / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D011725:Pyridines; D012367:RNA, Viral; D015215:Zidovudine; D019829:Nevirapine; D016049:Didanosine