{"id":7359,"date":"2005-05-15T18:43:39","date_gmt":"2005-05-15T17:43:39","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7359"},"modified":"2014-05-21T18:09:32","modified_gmt":"2014-05-21T18:09:32","slug":"lopinavirritonavir-for-young-infants","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7359","title":{"rendered":"Lopinavir\/ritonavir for young infants"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p><strong>Lopinavir\/ritonavir is increasingly recommended for treating young infants but in the absence of published data. Ellen Chadwick and colleagues from the PACTG 1030 study group evaluated dose requirements for babies &lt;6 months that provide systemic exposure similar to that which has been shown to be safe and effective in older children and adults.<\/strong><\/p>\n<p>Results were available for 12 infants (5 boys, 7 girls) and stratified by age: 14days to 6 weeks and 6 weeks to 6 months. A dose of 300 mg\/m2 lopinavir\/ 75mg\/m2 ritonavir was studied in combination with two nucleosides.<\/p>\n<p>Intensive PK studies were performed at two weeks with a dose adjustment if LPV\/r 12-hour post-dose concentration (C12) was &lt; 1 mg\/L; C12 was measured every 12 weeks and intensive pharmacokinetic studies were repeated if there was dose adjustment at one year of age.<\/p>\n<p>The study defined virologic success as viral load &lt; 400 copies\/mL at week 16; failure as never achieving &lt; 400 copies\/mL and late suppressors as achieving &lt; 400 copies\/mL after week 16. CD4 percentage was measured every 12 weeks.<\/p>\n<p>Median follow-up at analysis was 50 weeks (range 19 to 112 weeks). At entry, median age was 9.4 weeks (range 3.6 to 25.7 weeks), log10 HIV-1 RNA 5.6 (3.77 to 6.88) and CD4 percentage 37% (19 to 59%). Six of the 12 infants (50%) had virologic success, 2 (17%) virologic failure, and 4 (34%) were defined as late suppressors (&lt; 400 copies\/mL at week 32 to 48). The authors noted that poorer adherence contributed to poorer response.<\/p>\n<p>In 6 infants studied through week 36, CD4 percentage showed a median increase of 8% (\u20139 to +20%) from baseline.<\/p>\n<p>One infant required dose adjustment. Infants with virologic success vs virologic failure\/late suppressors were significantly younger (median 5.6 vs 15.9 weeks, p = 0.004).<\/p>\n<p>The authors found that the dose of 300 mg\/m2 LPV\/r twice daily was well tolerated in young infants and produced encouraging results in those infants adherent to therapy. At week 2 lower plasma concentrations were reported than found in adults despite a surface area adjusted dose approximately 35% higher than recommended for adults.<\/p>\n<p>To better define age-related differences in pharmacokinetics and response to LPV\/r, this group will study a second cohort of 12 infants.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base Lopinavir\/ritonavir is increasingly recommended for treating young infants but in the absence of published data. Ellen Chadwick and colleagues from the PACTG 1030 study group evaluated dose requirements for babies &lt;6 months that provide systemic exposure &hellip;<\/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-7359","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\/7359","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=7359"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7359\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7359"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7359"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7359"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}