Q and A

Question

What are the options to treat a multidrug resistant baby? Perhaps ibalizumab?

Is Ibalizumab approved for young children somewhere in the world?

If not, are there any ongoing clinical trials of Ibalizumab-based salvage regimens for children with multidrug-resistant HIV (incl. raltegravir, dolutegravir resistance unfortunately + they are CXCR4 tropic, so no use of maraviroc)?

Are there any, ANY options available anywhere?Doctors in our country (Ukraine) are not very helpful or specialized.

After genotyping the strain all we hear from them is “what were you thinking about when adopting an infant from Africa?” & ‘be prepared for you know what – there is nothing we can do”, etc.Perhaps there are some options in the West? We’re not poor, so can afford to buy meds… We just need some chances, however small they are, here in Ukraine we have no chances…

Please, sorry for English.

Answer

Hi

I am sorry, but ibalizumab is currently only approved as a treatment for adults in the US:
http://i-base.info/htb/33659

Approval in the EU is likely to follow but this will also only be for adults.

As with any case of drug resistance, this case sounds like if should be managed by a multidisciplinary team that will need to include a virologist that is an expert at interpreting drug resistance test.

This is more difficult than for adults because drugs used in adult are not always available or recommended for very young children.

Without the results it is difficult to suggest possible options – but perhaps boosted atazanavir might be an option if the baby is older than 3 month with lamivudine and any other meds that are still sensitive.

This booklet looks at different ways to treat drug resistance:
http://i-base.info/guides/changing

This includes a theoretical approach to cycling drugs that are already resistant:
http://i-base.info/guides/changing/drug-recycling-using-viral-fitness

Comment

Your e-mail address will not be published. Required fields are marked *