[New challenges in therapeutic management of human immunodeficiency virus-infected children].
More than 2 millions of children worldwide are HIV-infected. Recently, the HIV related mortality and morbidity has dramatically decreased due to the use of antiretroviral multitherapies in the HIV-infected children. However the therapeutic management of HIV-infected children is complex and may be complicated by socio-familial issues. Short and long term toxicity of antiretrovirals but also of HIV itself are of concern. Despite the good clinical and immunological results of antiretroviral multitherapies, virological failure may occur. Paediatric pharmacokinetic specificities and inadequate galenic presentation of drugs could lead to virological failure. However, the use of more potent drugs with more adapted presentation actually reduces this risk of failure. Prospective cohorts of HIV-infected children and new antiretroviral drugs paediatric evaluation are of key importance and can improve the paediatric therapeutic management. Finally, universal access to antiretroviral drugs in children, particularly in developing countries is the major actual and future challenge.
Faye
A
A
Service de pédiatrie générale de l'hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. albert.faye@rdb.ap-hop-paris.fr
D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D018450:Disease Progression; D004359:Drug Therapy, Combination; D014943:Global Health; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D011336:Probability; D016019:Survival Analysis
D019380:Anti-HIV Agents