Optimal dosing of lopinavir/ritonavir crucial in pediatric patients with HIV
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Higher doses of lopinavir/ritonavir may improve long-term viral load suppression in a group of Irish and British children with HIV, but larger studies are needed to confirm this finding, according to study data published online this month.
Sarah Walker, PhD, on behalf of the Collaborative HIV Paediatric Study (CHIPS), and colleagues looked at data on children who had taken daily doses of lopinavir/ritonavir (Kaletra, Aluvia; Abbott Laboratories) who were enrolled in CHIPS.
Walker and colleagues said 37% of 1,201 children had taken lopinavir/ritonavir without non-nucleoside reverse transcriptase inhibitors.
Overall, 141 children showed a suppressed viral load <400 copies/mL at 6 months, increasing from 62% in those receiving less than 414 mg/m2 to 64%, 70% and 75% in those receiving 414 mg/m2 to 530 mg/m2, 530 mg/m2 to 660 mg/m2 or more than 660 mg/m2, respectively (trend P=.21), Walker and colleagues said.
However, after adjusting for some variables, such as baseline viral load, “there was no evidence that a higher initial [lopinavir/ritonavir] dose improved virologic suppression … or that there was a difference between higher and lower dosing ranges (non-linearity P=.76), although the number of children included was small.”
The researchers said lopinavir/ritonavir dosing varied among hospitals, so their findings may have some important implications for prescription methods for children.
Children who received lower doses of medications received their medication once a day and received it in a syrup formulation — of 1,065 recorded doses, 48% were syrup, 27% capsules and 25% tablets.
Disclosure:The researchers report no relevant financial disclosures.