title: Effects of the change from Stavudine to tenofovir in human immunodeficiency virus-infected children treated with highly active antiretroviral therapy: studies on mitochondrial toxicity and thymic function.
abstract: BACKGROUND
  Changing from drugs that have significant mitochondrial toxicity to less toxic compounds may be of benefit in human immunodeficiency virus (HIV)-positive patients who receive highly active antiretroviral therapy. Few data on mitochondrial toxicity of antiviral drugs are available in HIV-positive children.
  
  
  METHODS
  Eighteen HIV-positive children (median age, 10.9 years) receiving a stavudine-containing regimen were randomized to maintain stavudine (arm A) or change to tenofovir (arm B), while preserving the remaining drugs. Glucose, lipidic, and viro-immunologic factors were assessed at months 0, 1, 3, 6, 12, and 18. Thymic output and mtDNA content were measured in peripheral blood mononuclear cells at 0 and 6 months, mtDNA in isolated CD4+ and CD8+ T cells after 18 months.
  
  
  RESULTS
  From baseline to month 6, arms A and B showed similar thymic output and mtDNA. After 18 months, a significant decrease in plasma HDL was observed in arm B, along with a small increase in blood glucose; mtDNA showed no difference. In the 2 arms other factors did not show significant differences from the baseline and from the previous values at 18 months.
  
  
  CONCLUSIONS
  Changing from stavudine to tenofovir was well-tolerated, and viro-immunologic success was maintained.
authors.affiliation: Infectious Diseases Clinics, San Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Rosso
authors.forename: Milena
authors.initials: M
authors.lastname: Nasi
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Biagio
authors.forename: Ernestina
authors.initials: E
authors.lastname: Repetto
authors.forename: Chiara
authors.initials: C
authors.lastname: Dentone
authors.forename: Marcello
authors.initials: M
authors.lastname: Pinti
authors.forename: Elisa
authors.initials: E
authors.lastname: Nemes
authors.forename: Roberta
authors.initials: R
authors.lastname: Ferraresi
authors.forename: Cristina
authors.initials: C
authors.lastname: Mussini
authors.forename: Roberto
authors.initials: R
authors.lastname: Esposito
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
authors.forename: Andrea
authors.initials: A
authors.lastname: Cossarizza
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001786:Blood Glucose; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000737:chemistry; D018414:CD8-Positive T-Lymphocytes / Q000737:chemistry; D002648:Child; D004272:DNA, Mitochondrial / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008928:Mitochondria / Q000187:drug effects*; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D018119:Stavudine / Q000009:adverse effects* / Q000627:therapeutic use; D000068698:Tenofovir; D013950:Thymus Gland / Q000502:physiology*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D001786:Blood Glucose; D004272:DNA, Mitochondrial; D008055:Lipids; D063065:Organophosphonates; D000068698:Tenofovir; D018119:Stavudine; D000225:Adenine