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Antiretrovirals in childrens

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https://www.readbyqxmd.com/read/29228317/leukocyte-telomere-length-at-birth-and-during-the-early-life-of-hiv-exposed-uninfected-children-following-in-utero-exposure-to-antiretrovirals
#1
Abhinav Ajaykumar, Hugo Soudeyns, Fatima Kakkar, Jason Brophy, Ari Bitnun, Ariane Alimenti, Arianne Y K Albert, Deborah M Money, Hélène C F Côté
Background: Maternal combination antiretroviral therapy (cART) during pregnancy could impact the health of HIV-exposed uninfected (HEU) children, as some antiretrovirals cross the placenta and can inhibit telomerase. Our objective was to compare HEU and HIV-unexposed uninfected (HUU) leukocyte telomere length (LTL) at birth and in early life, and investigate any relationship with cART exposure. Methods: HEU and HUU children's blood LTL was compared cross-sectionally at birth, and during the first three years of life...
December 8, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29227466/morbidity-and-mortality-of-a-cohort-of-peruvian-hiv-infected-children-2003-2012
#2
Amira N Baker, Angela M Bayer, Rolando M Viani, Lenka Kolevic, Myung-Shin Sim, Jaime G Deville
BACKGROUND: Data on pediatric HIV in Peru is limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under age 18 in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003-2012...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29227462/psychiatric-disorders-antiretroviral-medication-adherence-and-viremia-in-a-cohort-of-perinatally-hiv-infected-adolescents-and-young-adults
#3
Amelia Bucek, Cheng-Shiun Leu, Stephanie Benson, Patricia Warne, Elaine J Abrams, Katherine S Elkington, Curtis Dolezal, Andrew Wiznia, Claude Ann Mellins
BACKGROUND: Perinatally HIV-infected (PHIV+) adolescents and young adults (AYA) are at risk for sub-optimal antiretroviral therapy (ART) adherence, and mental health and substance use problems that, in HIV-infected adults, predict non-adherence. Studies on the relationship between psychiatric and substance use disorders (SUD) and adherence among PHIV+ AYA are limited, but may be important to informing evidence-based interventions to promote adherence. METHODS: Data were analyzed from three annual follow-up interviews (FU2-4, N=179) in a longitudinal study of PHIV+ AYA...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29227461/population-pharmacokinetics-of-lopinavir-in-severely-malnourished-hiv-infected-children-and-the-effect-on-treatment-outcomes
#4
Moherndran Archary, Helen Mcllleron, Raziya Bobat, Phillip La Russa, Thobekile Sibaya, Lubbe Wiesner, Stefanie Hennig
BACKGROUND: In developing countries, malnutrition remains a common clinical syndrome at antiretroviral treatment (ART) initiation. Physiological changes due to malnutrition and during nutritional recovery could affect the pharmacokinetics of antiretroviral drugs. METHODS: HIV-infected children admitted with severe acute malnutrition were randomised to early or delayed initiation of lopinavir/ritonavir, abacavir and lamivudine using WHO weight-band dosage charts...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29227424/effect-of-antiretroviral-therapy-on-growth-parameters-of-children-with-hiv-infection
#5
Anju Seth, Rajeev Kumar Malhotra, Rohini Gupta, Jagdish Chandra, Praveen Kumar, Sarita Singh, Garima Sharma
BACKGROUND: Children living with HIV (CLHIV) commonly experience growth failure. We report growth parameters in CLHIV at baseline and during 3 years of antiretroviral therapy (ART). METHODS: Records of CLHIV who had completed at least 3 years on ART were reviewed after excluding subjects who died, were lost to follow-up or developed treatment failure to assess impact of sustained administration of ART. Height-for-age (HFA) and body mass index for age (BFA) Z scores were calculated, and proportion of CLHIV with wasting and stunting estimated at baseline, 6, 12, 24 and 36 months after starting ART using the linear mixed model...
January 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29222960/drug-induced-acute-liver-failure-in-children-and-adults-results-of-a-single-center-study-of-128-patients
#6
Harshad Devarbhavi, Mallikarjun Patil, Vishnu Vardhan Reddy, Rajvir Singh, Tarun Joseph, Deepak Ganga
BACKGROUND AND AIMS: Drugs producing acute liver failure (ALF) are uncommon and vary geographically. Here we review the implicated drugs, clinical features, laboratory characteristics and outcome of patients with drug-induced ALF (DIALF). We analyzed the predictors of mortality and their relationship with MELD, Kings College criteria (KCC) and ALFSG prognostic index. METHODS: We identified DIALF patients from our drug-induced liver injury (DILI) registry (1997-2017)...
December 9, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29220598/hope-for-the-future-but-fear-the-risk-of-stigma-ethiopian-family-caregivers-lived-experience-of-caring-for-their-hiv-positive-child-two-years-after-starting-antiretroviral-treatment
#7
Mulatu Biru, Pia Lunqvist, Mitikie Molla, Degu Jerene, Inger Hallström
Family caregivers are believed to be the primary source of support for HIV-affected children. There is limited evidence about practices of support for caregivers, to strengthen them and to enhance the welfare of HIV positive children, especially in African settings. Our aim was therefore to illuminate caregivers' lived experiences of caring for a child in Ethiopia 2 years after the child was enrolled in antiretroviral therapy. Qualitative interviews with 18 family caregivers of 18 children were performed and analyzed using an inductive design with a hermeneutic phenomenological approach...
December 8, 2017: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29219134/does-infant-feeding-method-influence-the-incidence-and-pattern-of-morbidities-among-human-immunodeficiency-virus-exposed-uninfected-nigerian-infants
#8
Olusoga Babatunde Ogunfowora, Tinuade Adetutu Ogunlesi, Abiodun Folashade Adekanmbi, Victor Ayodeji Ayeni
BACKGROUND: Human immunodeficiency virus (HIV)-exposed infants enrolled into the prevention of mother-to-child transmission of HIV program generally receive antiretroviral therapy (ARV), but the feeding methods differ based on several socioeconomic and cultural differences. OBJECTIVE: The objective of the study was to examine the incidence and pattern of morbidities among HIV-exposed uninfected (HEU) Nigerian infants and determine any relationship with infant feeding methods...
October 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/29218008/improving-the-adherence-to-antiretroviral-therapy-a-difficult-but-essential-task-for-a-successful-hiv-treatment-clinical-points-of-view-and-practical-considerations
#9
REVIEW
Simona A Iacob, Diana G Iacob, Gheorghita Jugulete
HIV infection is responsible for one the most devastating human pandemics. The advent of antiretroviral therapy has changed the course of the pandemic and saved millions of lives. Complex therapeutic regimens have been introduced since 1996 and have contributed to the transformation of HIV infection into a treatable chronic diseases. New types of potent antiretrovirals and their combinations, including "once daily" treatment, have simplified the regimens and diminished side effects. Nevertheless the adherence to antiretroviral therapy remains unsatisfactory and varies between 27 and 80% across different population in various studies, compared with the required level of 95%...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29209922/altered-brain-morphometry-in-7-year-old-hiv-infected-children-on-early-art
#10
Emmanuel C Nwosu, Frances C Robertson, Martha J Holmes, Mark F Cotton, Els Dobbels, Francesca Little, Barbara Laughton, Andre van der Kouwe, Ernesta M Meintjes
Even with the increased roll out of combination antiretroviral therapy (cART), paediatric HIV infection is associated with neurodevelopmental delays and neurocognitive deficits that may be accompanied by alterations in brain structure. Few neuroimaging studies have been done in children initiating ART before 2 years of age, and even fewer in children within the critical stage of brain development between 5 and 11 years. We hypothesized that early ART would limit HIV-related brain morphometric deficits at age 7...
December 5, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29209538/disclosure-of-parental-hiv-status-to-children-experiences-of-adults-receiving-antiretroviral-treatment-at-an-urban-clinic-in-kampala-uganda
#11
Charles Peter Osingada, Monica Okuga, Rose Chalo Nabirye, Nelson Kaulukusi Sewankambo, Damalie Nakanjako
Limited data are available on the experiences of parental HIV disclosure to children in Uganda. We conducted a qualitative study comprising sixteen in-depth interviews and four focus group discussions with parents receiving highly active antiretroviral therapy. Analysis was done using Atlas.ti qualitative research software. Back-and-forth triangulation was done between transcripts of the in-depth interviews and focus group discussions, and themes and subthemes were developed. Barriers to parents' disclosure included perceptions that children are too young to understand what HIV infection means and fears of secondary disclosure by the children...
2017: AIDS Research and Treatment
https://www.readbyqxmd.com/read/29206748/pharmacokinetics-and-pharmacodynamics-of-atazanavir-in-hiv-1-infected-children-treated-with-atazanavir-powder-and-ritonavir-combined-analysis-of-the-prince-1-and-2-studies
#12
Heather Sevinsky, Luna Zaru, Reena Wang, Xiaohui Xu, Cheryl Pikora, Todd A Correll, Timothy Eley
BACKGROUND: Two clinical studies (PRINCE-1 and -2) in HIV-1-infected children assessed the safety, efficacy, and pharmacokinetics of dual nucleos(t)ide reverse transcriptase inhibitor (NRTI) background therapy plus once-daily atazanavir powder formulation boosted with ritonavir (ATV+RTV). Here, we present a combined analysis of ATV pharmacokinetics and pharmacodynamics across these studies. METHODS: Intensive 24-hour pharmacokinetic profiles at steady state compared ATV exposures (area under the concentration-time curve in one dosing interval [AUCτ]) in 5 ATV+RTV baseline weight-band dosing categories with historic data in adults receiving ATV+RTV 300/100-mg capsules...
December 4, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29206747/safety-and-efficacy-of-atazanavir-powder-and-ritonavir-in-hiv-1-infected-infants-and-children-aged-from-3-months-to-11-years-the-prince-2-study
#13
Mark F Cotton, Afaaf Liberty, Indiana Torres-Escobar, Maria Isabel Gonzalez-Tome, Jurgen Lissens, Luna Zaru, Isabelle Klauck, Daniela Cambilargiu, Cheryl Pikora, Todd A Correll
BACKGROUND: Novel antiretroviral formulations that are palatable, safe, and effective are needed for infants and children. METHODS: PRINCE-2 is an ongoing clinical trial assessing safety, efficacy, and palatability of once-daily atazanavir powder formulation boosted with ritonavir (ATV+RTV) plus optimized dual NRTI therapy in ARV-naïve/experienced children with screening HIV-1 RNA ≥1000 copies/mL. Children aged 3 months to <11 years received ATV+RTV by 5 baseline weight bands: 5 to <10kg=150/80mg; 5 to <10kg=200/80mg; 10 to <15kg=200/80mg; 15 to <25kg=250/80mg; and 25 to <35kg=300/100mg...
December 4, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29206312/risk-of-cancer-in-children-exposed-to-antiretroviral-nucleoside-analogues-in-utero-the-french-experience
#14
Mira Hleyhel, Stéphanie Goujon, Jeanne Sibiude, Roland Tubiana, Catherine Dollfus, Albert Faye, Laurent Mandelbrot, Jacqueline Clavel, Josiane Warszawski, Stéphane Blanche
All nucleoside analogues for treating HIV infection, due to their capacity to integrate into and alter human DNA, are experimentally genotoxic to some extent. The long-term oncogenic risk after in utero exposure remains to be determined. Cancer incidence in uninfected children exposed to nucleos(t)ide reverse transcriptase inhibitors (NRTIs) was evaluated, by cross-checking against the National Cancer Registry, in the French perinatal study of children born to HIV+ mothers. Twenty-one cancers were identified in 15,163 children (median age: 9...
December 5, 2017: Environmental and Molecular Mutagenesis
https://www.readbyqxmd.com/read/29201656/age-stratified-tuberculosis-treatment-outcomes-in-zimbabwe-are-we-paying-attention-to-the-most-vulnerable
#15
R T Ncube, K C Takarinda, C Zishiri, W van den Boogaard, N Mlilo, C Chiteve, N Siziba, F Trinchán, C Sandy
Setting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly...
September 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29200184/structural-neuroimaging-and-neuropsychologic-signatures-of-vertically-acquired-hiv
#16
Robert Paul, Wasana Prasitsuebsai, Neda Jahanashad, Thanyawee Puthanakit, Paul Thompson, Linda Aurpibul, Rawiwan Hansudewechakul, Pope Kosalaraksa, Suparat Kanjanavanit, Chaiwat Ngampiyaskul, Wicharn Luesomboon, Sukalaya Lerdlum, Mantana Pothisri, Pannee Visrutaratna, Victor Valcour, Talia M Nir, Arvin Saremi, Stephen Kerr, Jintanat Ananworanich
BACKGROUND: Children with vertically acquired human immunodeficiency virus (HIV) exhibit persistent cognitive impairments, yet the corresponding neuroimaging signature of vertical infection remains unclear. METHODS: Fifty healthy control children and 51 vertically infected children were included in the study. The HIV-infected group consisted of survivors who had not received antiretroviral therapy (ART) at birth. The HIV-infected group averaged 11.4 (2.5) years of age, with a median CD4 count of 683 cells/mm...
December 1, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29190337/optimizing-research-to-speed-up-availability-of-pediatric-antiretroviral-drugs-and-formulations
#17
Martina Penazzato, Devasena Gnanashanmugam, Pablo Rojo, Marc Lallemant, Linda L Lewis, Francesca Rocchi, Agnes Saint Raymond, Nathan Ford, Rohan Hazra, Carlo Giaquinto, Yodit Belew, Diana M Gibb, Elaine J Abrams
Globally 1.8 million children are living with human immunodeficiency virus (HIV), yet only 51% of those eligible actually start treatment. Research and development (R&D) for pediatric antiretrovirals (ARVs) is a lengthy process and lags considerably behind drug development in adults. Providing safe, effective, and well-tolerated drugs for children remains critical to ensuring scale-up globally. We review current approaches to R&D for pediatric ARVs and suggest innovations to enable simplified, faster, and more comprehensive strategies to develop optimal formulations...
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29189659/high-prevalence-of-lipid-abnormalities-and-insulin-resistance-among-antiretroviral-na%C3%A3-ve-hiv-infected-children-in-india
#18
Chandrasekaran Padmapriyadarsini, Anita Shet, Ramalingam Srinivasan, Geetha Ramachandran, G N Sanjeeva, Poornaganga Devi, Karunainathan Ramesh, Perumal Kannabiran Bhavani, Devaraj Reddy, Elumalai Suresh, Chockalingam Chandrasekhar, Christine Wanke, Soumya Swaminathan
BACKGROUND: As large numbers of children are accessing antiretroviral therapy (ART) in India, we evaluated the dietary intake, growth pattern and risk of metabolic complications like dyslipidemia and insulin resistance among ART-naïve HIV infected children (CLHIV). METHODS: CLHIV aged 2-12 years, at the time of initiating ART in Chennai and Bangalore, were assessed for their dietary intake, anthropometry, blood CD4 cell count, HIV-1 viral load, fasting serum lipids, glucose and insulin...
November 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29189606/moyamoya-syndrome-in-a-child-with-hiv-1-infection
#19
Ankur Kumar Jindal, Sagar Bhattad, Deepti Suri, Manphool Singhal, Aman Gupta, Paramjeet Singh
Neurological manifestations of HIV infection are not uncommon. However, stroke secondary to Moyamoya syndrome has rarely been described in children with HIV infection. We report a 10 years old boy with perinatally acquired HIV-1-infection, who presented with recurrent strokes while on antiretroviral therapy.
November 15, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29189416/the-treatment-cascade-in-children-with-unsuppressed-viral-load-a-reality-check-in-rural-lesotho-southern-africa
#20
Thabo Ishmael Lejone, Isaac Ringera, Molisana Cheleboi, Sarah Wagner, Josephine Muhairwe, Thomas Klimkait, Niklaus Daniel Labhardt
BACKGROUND: As per guidelines of the World Health Organization HIV infected children who do not achieve viral suppression while under antiretroviral therapy (ART), receive enhanced adherence counselling (EAC) with follow-up viral load (VL). A persisting unsuppressed VL after EAC triggers switch to a second-line regimen. We describe the care cascade of children with unsuppressed VL while taking ART. METHODS: Children, aged <16 years, on first-line ART for ≥6 months with unsuppressed VL (≥80copies/mL) at first measurement were enrolled...
November 17, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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