{"id":7355,"date":"2005-05-15T18:40:13","date_gmt":"2005-05-15T17:40:13","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7355"},"modified":"2014-05-21T18:10:23","modified_gmt":"2014-05-21T18:10:23","slug":"switching-d4t-to-tenofovir-and-protease-inhibitor-to-efavirenz","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7355","title":{"rendered":"Switching d4T to tenofovir and protease inhibitor to efavirenz"},"content":{"rendered":"

Alessandra Vigan\u00f2 and colleagues reported findings from a study to assess the strategy of replacing protease inhibitor (PI) by efavirenz (EFV) and stavudine (d4T) by tenofovir (TDF) in HIV-positive children with long-lasting viral suppression.<\/strong><\/p>\n

In this study, 27 HIV-positive children (age range 5.0 to 17.5 years) with viral load < 50 copies\/mL for the last 48 weeks, on HAART containing lamivudine (3TC) + d4T+ 1 PI were randomised either to switch d4T to TDF and PI to EFV at baseline (n = 14; group A) or at week 24 (n = 13; group B).<\/p>\n

All children maintained 3TC and were followed with clinical assessment, viral load, CD4 count, fasting metabolic, and renal parameters for 48 weeks.<\/p>\n

The authors reported from baseline to week 24 and at week 48, both groups had unchanged CD4 count 884, 759, 848 vs 809, 795, 754 cells\/mm3; HIV RNA < 50 copies\/mL; unchanged and normal levels of serum creatinine, phosphate, calculated creatinine clearance; absence of proteinuria and glycosuria.<\/p>\n

The children in Group A, from baseline to week 24, showed a significant decrease on total cholesterol (\u201320%, p< 0.03), triglycerides (\u201335%, p< 0.05) and total cholesterol\/HDL ratio from 3.5 to 3.0, p< 0.006); and at week 48, the authors reported stable cholesterol levels and a further decrease of triglycerides and HDL cholesterol. Children in this group with elevated (> 95th percentile for age and sex) cholesterol and triglyceride levels showed a marked decrease of both over the study period (from 43 to 0% and from 36 to 7%, respectively).<\/p>\n

In Group B, from baseline to week 24, the children showed unchanged cholesterol, triglycerides, HDL cholesterol and percentage of HIV with elevated cholesterol and triglyceride levels; at week 48, the authors reported a significant decrease of cholesterol (\u201314%; p < 0.03), triglycerides (\u201341%; p < 0.05), and HDL cholesterol (from 3.9 to 3.2; p < 0.006). The children with elevated cholesterol and triglyceride levels showed marked reduction of both after the initiation of the new regimen (from 46 to 8% and from 54 to 0%, respectively).<\/p>\n

No adverse events were reported throughout this study.<\/p>\n

The authors concluded: \u201cThe replacement of PI by EFV and d4T by TDF in HIV-infected children who had been receiving a HAART regimen containing 3TC+d4T+PI who had long lasting viral suppression provides continued virological suppression, stable CD4 response.<\/p>\n

References:<\/p>\n

    \n
  1. Verweel G, van der Lee M, Burger D et al. 6-Month follow-up of once-daily lopinavir\/ritonavir in HIV-1-infected children. 12th CROI Boston 2005 Abstract 769.<\/li>\n
  2. Chadwick EG, Rodman J, Palumbo P et al. A prospective evaluation of pharmacologic, virologic, and immunologic parameters of lopinavir\/ritonavir for HIV-1-infected infants < 6 months of age. 12th CROI, Boston 2005. Abstract 766.<\/li>\n
  3. Kiser J, Rutstein R, Aldrovandi G et al. Pharmacokinetics of atazanavir\/ritonavir in HIV-infected infants, children, and adolescents: PACTG 1020A. 12th CROI, Boston 2005. Abstract 767.<\/li>\n
  4. Vigan\u00f2 A, V Giacomet V, Beretta S et al. Switching stavudine to tenofovir and protease inhibitor to efavirenz results in a favourable clinical outcome in HIV-infected children. 12th CROI, Boston 2005. Abstract 770.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Alessandra Vigan\u00f2 and colleagues reported findings from a study to assess the strategy of replacing protease inhibitor (PI) by efavirenz (EFV) and stavudine (d4T) by tenofovir (TDF) in HIV-positive children with long-lasting viral suppression. In this study, 27 HIV-positive children …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,32],"tags":[59],"class_list":["post-7355","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-paediatric-care","tag-croi-2005"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=7355"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7355\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7355"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7355"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}