[Anti-retroviral treatment of HIV infection in the child].
The treatment of HIV infection has changed recently in children and adults. The new guidelines are based on a better knowledge of viral pathogenesis, control of the infection and treatment effectiveness using the viral load, and the availability of new antiretroviral drugs. Cumulative clinical experience and the results of therapeutic trials suggest that treatment should begin early, before immune system disorders occur, in order to prevent viral dissemination and neurological involvement. Combined therapy with at least two drugs is recommended, although triple therapy with two inhibitors of inverse transcriptase and a protease inhibitor is advised as a way to delay the appearance and selection of resistant viral strains. Given the complexity of these treatment guidelines, the side effects of antiretroviral agents, and drug interactions with many medications, meticulous and detailed information for the family and child is necessary to ensure compliance and guarantee therapeutic effectiveness. The object should be to achieve an individualized and rational therapy that is adapted to the childís schedule and uses the drug formulation that the child best tolerates. The are reasons for optimism because new drugs are being developed and many of our patients will undoubtedly benefit from them. However, it should not be forgotten that many children with HIV infection in the third world cannot receive treatment for social and economic reasons.
Servicio Infecciosos, Hospital Infantil La Paz, Madrid.
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MI
De José Gómez
D015526:AIDS Dementia Complex / Q000517:prevention & control; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use*; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D018450:Disease Progression; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007223:Infant; D014779:Virus Replication / Q000187:drug effects
D019380:Anti-HIV Agents; D015415:Biomarkers; D017320:HIV Protease Inhibitors; D054303:HIV Reverse Transcriptase