title: Nucleoside-analogue reverse-transcriptase inhibitors plus nevirapine, nelfinavir, or ritonavir for pretreated children infected with human immunodeficiency virus type 1.
abstract: The relative potency and tolerability of multidrug regimens used to treat infants and children infected with human immunodeficiency virus type 1 (HIV-1) are largely unknown. In Pediatric AIDS Clinical Trials Group (PACTG) Protocol 377, 181 infants and children were assigned to receive stavudine (d4T) plus nevirapine (NVP) and ritonavir (RTV); d4T plus lamivudine (3TC) and nelfinavir (NFV); d4T plus NVP and NFV; or d4T plus 3TC, NVP, and NFV. Eleven additional children received d4T and NVP plus NFV given twice daily. All subjects had not previously received protease inhibitors or nonnucleoside reverse-transcriptase inhibitors and all had been immunologically stable while receiving reverse-transcriptase inhibitor therapy. After 48 weeks of therapy, 17 (41%) of 41 subjects receiving d4T-NVP-RTV, 13 (30%) of 44 receiving d4T-NVP-NFV, 21 (42%) of 50 receiving d4T-3TC and NFV (3 times daily), and 22 (52%) of 42 receiving d4T-3TC-NVP-NFV were still receiving their assigned therapy and had HIV-1 RNA suppression to </= 400 copies/mL. These regimens were similar in their drug activity, but the 4-drug regimen offered slightly more durable suppression of viremia.
authors.affiliation: University of California, Los Angeles School of Medicine, Departments of Pediatrics and Molecular and Medical Pharmacology, Los Angeles, CA, 90095, USA. pkrogstad@mednet.ucla.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Krogstad
authors.forename: Sophia
authors.initials: S
authors.lastname: Lee
authors.forename: George
authors.initials: G
authors.lastname: Johnson
authors.forename: Kenneth
authors.initials: K
authors.lastname: Stanley
authors.forename: James
authors.initials: J
authors.lastname: McNamara
authors.forename: John
authors.initials: J
authors.lastname: Moye
authors.forename: J Brooks
authors.initials: JB
authors.lastname: Jackson
authors.forename: Rosaura
authors.initials: R
authors.lastname: Aguayo
authors.forename: Arry
authors.initials: A
authors.lastname: Dieudonne
authors.forename: Margaret
authors.initials: M
authors.lastname: Khoury
authors.forename: Hermann
authors.initials: H
authors.lastname: Mendez
authors.forename: Sharon
authors.initials: S
authors.lastname: Nachman
authors.forename: Andrew
authors.initials: A
authors.lastname: Wiznia
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D019888:Nelfinavir / Q000009:adverse effects / Q000627:therapeutic use; D019829:Nevirapine / Q000009:adverse effects / Q000627:therapeutic use; D012367:RNA, Viral / Q000187:drug effects / Q000378:metabolism; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019438:Ritonavir / Q000009:adverse effects / Q000627:therapeutic use; D018119:Stavudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D019829:Nevirapine; D018119:Stavudine; D019888:Nelfinavir; D019438:Ritonavir