title: Simplifying antiretroviral therapy to lopinavir/ritonavir monotherapy did not improve quality of life and therapy adherence in pretreated HIV-infected children.
abstract: We reported quality of life (QOL) and adherence in HIV-infected children after simplifying the antiretroviral regimen by switching to lopinavir/ritonavir monotherapy (mLPV/r). HIV-infected children with HIV-RNA <50 copies/ml while using second-line double boosted protease inhibitors were switched to mLPV/r. Primary caregivers completed PACTG QOL questionnaires at weeks 0, 48, 96, and 144. Adherence by pill count was performed at every visit. Thirty-eight pretreated HIV-infected Thai children were enrolled. The median (IQR) age was 11.5 (10.2-13.2) years and 53% were female. At enrollment, 34 used LPV/r+saquinavir and four used LPV/r+indinavir. The median (IQR) CD4% was 27 (23-30)%. At week 144, QOL scores were similar to baseline for all domains. A transient increase in the symptoms domain score was seen at week 96 (p=0.01), whereas the physical resilience domain score was decreased at weeks 48 and 96 (both p<0.05). Despite the mean number of pills decreasing from 7.9 pills/day before and 3.7 pills/day after mLPV/r (p<0.001), there were no differences over time in adherence rates by pill count and proportion of children with poor adherence (all p>0.05). Our study did not demonstrate improvement of QOL scores and adherence rates by pill count in pretreated HIV-infected children after simplification of the antiretroviral regimen to lopinavir/ritonavir monotherapy.
authors.affiliation: 1 The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre , Bangkok, Thailand .
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
authors.forename: Apirudee
authors.initials: A
authors.lastname: Panthong
authors.forename: Pope
authors.initials: P
authors.lastname: Kosalaraksa
authors.forename: Jiratchaya
authors.initials: J
authors.lastname: Wongsabut
authors.forename: Thanyawee
authors.initials: T
authors.lastname: Puthanakit
authors.forename: Pagakrong
authors.initials: P
authors.lastname: Lumbiganon
authors.forename: Thongsuai
authors.initials: T
authors.lastname: Chuanjaroen
authors.forename: Chanasda
authors.initials: C
authors.lastname: Sopharak
authors.forename: Thanitta
authors.initials: T
authors.lastname: Udompanit
authors.forename: Wasana
authors.initials: W
authors.lastname: Prasitsuebsai
authors.forename: Chitsanu
authors.initials: C
authors.lastname: Pancharoen
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D061466:Lopinavir / Q000627:therapeutic use*; D008297:Male; D011788:Quality of Life; D019438:Ritonavir / Q000627:therapeutic use*; D013785:Thailand; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents; D061466:Lopinavir; D019438:Ritonavir