ART more effective than NRTI-only regimens for children, adolescents

Using only nucleoside reverse transcriptase inhibitors did not offer the same duration of protection or benefits as pediatric patients treated with antiretroviral therapy, according to results from a 6-month study.

Michael Neely, MD, MSc, of the University of Southern California, and colleagues published data from 575 children and adolescents who had been observed since their initial diagnosis through 2006. The study is part of the LEGACY consortium, which is a CDC-funded, observational, prospective cohort study of US patients with HIV who are aged 0 to 24 years.

Michael Neely

“Virologic outcomes, including the percentage of participants with a plasma HIV RNA viral load <400 copies/mL at week 24 (47% vs. 34%) and the mean 24-week change in log₁₀ plasma HIV RNA viral load from baseline (–0.63 vs. –1.02) were similar between [the two groups], but virologic rebound was more likely in the [nucleoside reverse transcriptase inhibitors]-only participants (77% vs. 54%, P=.02),” the researchers wrote.

Neely and colleagues concluded that these findings support the current pediatric HIV ART treatment guidelines that recommend nucleoside reverse transcriptase inhibitors (NRTIs) not be used as initial therapy for pediatric patients who have alternative treatment options.

Neely and colleagues noted some study limitations, specifically that it was not possible to match further criteria such as age or treatment regimen number. In addition, the numbers in the primary cohort and for analyses of the overall cohort beyond 24 weeks were small. The investigators said these factors may have introduced biases into their analyses.

For more information:

NIH. Guidelines for the use of antiretroviral agents in pediatric HIV infection. Available at: http://aidsinfo.nih.gov/guidelines/html/2/pediatric-arv-guidelines/0/. Accessed April 4, 2013.

Disclosure: Neely reports no relevant financial disclosures.