Effect of combination antiretroviral therapy on cerebrospinal fluid HIV RNA, HIV resistance, and clinical manifestations of encephalopathy.
J Pediatr
; 141(1): 36-44, 2002 Jul.
Article
em En
| MEDLINE
| ID: mdl-12091849
OBJECTIVES: This study evaluated the effect of treatment with abacavir/lamivudine/zidovudine versus lamivudine/zidovudine on cerebrospinal fluid (CSF) human immunodeficiency virus (HIV) RNA and clinical manifestations of HIV encephalopathy in children. STUDY DESIGN: HIV-infected children 7 months to 10 years of age (n = 23) were studied. CSF and plasma were obtained at baseline and weeks 8, 16, and 48. Genotype analysis of HIV was attempted at baseline and week 48. Neurologic evaluations were performed at baseline and weeks 16, 32, and 48. RESULTS: At baseline, 83% of children had >2.00 log(10) copies/mL HIV RNA in CSF, but only 10% had HIV RNA measurable at week 48. Among children in whom paired genotyping of HIV was possible, 8 of 11 had identical patterns in both CSF and plasma at baseline, whereas at week 48, only 1 of 9 children had similar patterns. Neurologic abnormalities were observed in 83% of children at baseline but only 35% of children at week 48 (P =.004), suggesting a benefit of treatment. CONCLUSIONS: Antiretroviral therapy was associated with a decline in CSF HIV RNA and an improvement in neurologic status. The development of genotypic mutations was different in CSF and plasma, suggesting discordant viral evolution. These results suggest that antiretroviral treatment in children should include agents with activity in the CNS.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Didesoxinucleosídeos
/
Zidovudina
/
Complexo AIDS Demência
/
HIV-1
/
Lamivudina
/
Fármacos Anti-HIV
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Child
/
Child, preschool
/
Humans
/
Infant
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Estados Unidos