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Rilpivirine in childrens

Rajith K R Rajoli, David J Back, Steve Rannard, Caren Freel Meyers, Charles Flexner, Andrew Owen, Marco Siccardi
BACKGROUND AND OBJECTIVES: Long-acting injectable antiretrovirals represent a pharmacological alternative to oral formulations and an innovative clinical option to address adherence and reduce drug costs. Clinical studies in children and adolescents are characterised by ethical and logistic barriers complicating the identification of dose optimisation. Physiologically-based pharmacokinetic modelling represents a valuable tool to inform dose finding prior to clinical trials. The objective of this study was to simulate potential dosing strategies for existing long-acting injectable depot formulations of cabotegravir and rilpivirine in children and adolescents (aged 3-18 years) using physiologically-based pharmacokinetic modelling...
February 2018: Clinical Pharmacokinetics
Shanmugam Saravanan, Bagavathi Kausalya, Selvamurthi Gomathi, Sathasivam Sivamalar, Balakrishnan Pachamuthu, Poongulali Selvamuthu, Amrose Pradeep, Solomon Sunil, Sarvode N Mothi, Davey M Smith, Rami Kantor
We have analyzed reverse transcriptase (RT) region of HIV-1 pol gene from 97 HIV-infected children who were identified as failing first-line therapy that included first-generation non-nucleoside RT inhibitors (Nevirapine and Efavirenz) for at least 6 months. We found that 54% and 65% of the children had genotypically predicted resistance to second-generation non-nucleoside RT inhibitors drugs Etravirine (ETR) and Rilpivirine, respectively. These cross-resistance mutations may compromise future NNRTI-based regimens, especially in resource-limited settings...
June 2017: AIDS Research and Human Retroviruses
Lola Falcon-Neyra, Claudia Palladino, María Luisa Navarro Gómez, Pere Soler-Palacín, María Isabel González-Tomé, Santiago J De Ory, Marie Antoinette Frick, Clàudia Fortuny, Antoni Noguera-Julian, Elena Bermúdez Moreno, Juan Luis Santos, Peter Olbrich, Luis F López-Cortés, Verónica Briz, Olaf Neth
To assess the safety and efficacy of rilpivirine in combination with emtricitabine and tenofovir (RPV/FTC/TDF) as a once-daily single-tablet regimen (STR) in HIV-1-infected children and adolescents we performed a multicenter case series study of HIV-1-infected patients. Inclusion criteria were initiation of therapy with RPV/FTC/TDF before the age of 18. Patients were divided into undetectable viral load (uVL) group, HIV-1 RNA < 20 copies/mL on stable combined antiretroviral therapy (cART), and detectable viral load (dVL) group, HIV-1 RNA ≥ 20 copies/mL at RPV/FTC/TDF initiation...
June 2016: Medicine (Baltimore)
Nathan Ford, Zara Shubber, Anton Pozniak, Marco Vitoria, Meg Doherty, Catherine Kirby, Alexandra Calmy
INTRODUCTION: Efavirenz (EFV) is widely used for the treatment of antiretroviral-naive HIV-positive individuals, but there are concerns about the risk of adverse neuropsychiatric events. We systematically reviewed the safety of EFV in first-line therapy. METHODS: Four databases were searched until October 2014 for randomized trials comparing EFV against non-EFV-based regimens for the treatment of antiretroviral-naive HIV-positive adults and children. The primary outcome was drug discontinuation as a result of any adverse event...
August 1, 2015: Journal of Acquired Immune Deficiency Syndromes: JAIDS
P Rojas Sánchez, M de Mulder, E Fernandez-Cooke, L Prieto, P Rojo, S Jiménez de Ory, M José Mellado, M Navarro, J Tomas Ramos, Á Holguín
Drug resistance mutations compromise the success of antiretroviral treatment in human immunodeficiency virus type 1 (HIV-1)-infected children. We report the virologic and clinical follow-up of the Madrid cohort of perinatally HIV-infected children and adolescents after the selection of triple-class drug-resistant mutations (TC-DRM). We identified patients from the cohort carrying HIV-1 variants with TC-DRM to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors according to IAS-USA-2013...
June 2015: Clinical Microbiology and Infection
Chloe Orkin, David A Wohl, Andrew Williams, Henri Deckx
Vitamin D deficiency in HIV infection has attracted much interest. The best known clinical outcomes of vitamin D deficiency are rickets (children) and osteomalacia (adults). Several non-skeletal disorders have also been linked to suboptimal vitamin D levels in the general population. The prevalence of vitamin D deficiency varies widely (6-100%) across diverse patient populations, with no evidence that it is higher in HIV-positive versus noninfected adults. Vitamin D deficiency may blunt immune restoration and exacerbate HIV complications (e...
April 2014: AIDS Reviews
Nathan Ford, Janice Lee, Isabelle Andrieux-Meyer, Alexandra Calmy
The vast majority of people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome reside in the developing world, in settings characterized by limited health budgets, critical shortages of doctors, limited laboratory monitoring, a substantial burden of HIV in children, and high rates of coinfection, in particular tuberculosis. Therefore, the extent to which new antiretrovirals will contribute to improvements in the management of HIV globally will depend to a large extent on their affordability, ease of use, low toxicity profile, availability as pediatric formulations, and compatibility with tuberculosis and other common drugs...
2011: HIV/AIDS: Research and Palliative Care
Martina Penazzato, Carlo Giaquinto
The first-generation non-nucleoside reverse transcriptase inhibitors (NNRTIs), efavirenz and nevirapine, fulfil key roles in antiretroviral therapy for HIV-infected paediatric patients, from lowering the incidence of mother-to-child transmission during pregnancy and birth to treatment throughout childhood and adolescence. Both agents have established efficacy, safety and tolerability profiles, and also offer advantages over other classes of therapy in terms of regimen simplicity and availability across different treatment settings...
November 12, 2011: Drugs
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