title: Special considerations concerning the use of antiretroviral drugs in children.
abstract: Antiretroviral therapy is extremely effective in both children and adults infected with HIV. Treatment indications have rapidly expanded; ideally, with rare exceptions, all infected children should now be treated. Areas covered: The use of antiretroviral drugs in children is based largely on extrapolations from experience with adult patients. Pharmacokinetic studies are required in addition to formal studies, which are difficult to conduct in pediatric situations, extending from birth to adolescence. However, despite often inadequate galenic formulation, treatment of children is easier than generally thought. No major or irreversible toxicity has been observed with the latest generation of molecules. Several observations suggest that very early treatment, beginning shortly after birth, provides better long-term immunological control of infection. Expert commentary: All HIV-infected children should be treated with antiretroviral drugs. Manufacturers should propose appropriate dosage forms, including combined forms in particular, and should support pharmacological and tolerance studies in pediatric patients of various ages. Very early treatment maximizes the chances of long-term immunological control.
authors.affiliation: a Microbiology Laboratory , Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP) , Paris , France.|b Immuno-Hematology Unit, Department of Pediatrics , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP) , Paris , France.|c EA7327, Université Paris Descartes, Sorbonne Paris Cité , Paris , France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Frange
authors.affiliation: d EA7323 Université Paris Descartes Sorbonne Paris Cité , Paris , France.|e Clinical Research Unit 1419 INSERM, Cochin-Necker , Paris.
authors.forename: Naïm
authors.initials: N
authors.lastname: Bouazza
authors.affiliation: f Elizabeth Glaser Pediatric AIDS Foundation , Abidjan , Côte d'Ivoire.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fassinou
authors.affiliation: g CESP INSERM U1018 , Le Kremlin-Bicêtre , France.|h Université Paris-Sud , Le Kremlin-Bicêtre , France.
authors.forename: Josiane
authors.initials: J
authors.lastname: Warszawski
authors.affiliation: b Immuno-Hematology Unit, Department of Pediatrics , Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP) , Paris , France.|d EA7323 Université Paris Descartes Sorbonne Paris Cité , Paris , France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Blanche
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D018572:Disease-Free Survival; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D017410:Practice Guidelines as Topic
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; antiretroviral therapy; children; pharmacology; tolerance