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3rd International AIDS Society Conference on HIV Pathogenesis and TreatmentRio de Janeiro - July 24 - 27, 2005 |
EARLY EFFECTIVENESS OF TRIOMUNE IN HIV INFECTED UGANDAN CHILDREN
IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WeOa0103
Barlow-Mosha L.1, Musoke P.2, Ajuna P.1, Luttajumwa M.1, Walabyeki J.1, Owor M.1, Mubiru M.1
1Makerere University – Johns Hopkins University Research Collaboration, Kampala, Uganda, 2Makerere University – Johns Hopkins University Research Collaboration, Department of Pediatrics Makerere University, Kampala, Uganda
INTRODUCTION: With the introduction of cheaper antiretroviral drugs and international donations more Ugandans are accessing Highly Active Antiretroviral Therapy (HAART). However, children are often left out because of the lack of infant diagnostic tests, limited appropriate drug formulations and inadequate knowledge on antiretroviral drug use in children.
OBJECTIVES: To determine the effectiveness of generic fixed dose combination tablet (Triomune-d4T/3TC/NVP) in HIV infected Ugandan children.
METHODS: HIV infected children from the perinatal prevention trials at MU-JHU and Paediatric Infectious Disease clinic, Mulago were screened for antiretroviral therapy. Triomune was prescribed according to specific weight ranges. A t-test was performed to compare CD4 cell counts and viral load at baseline versus 12 weeks, 24 weeks and 36 weeks post-therapy.
RESULTS: One hundred fifty-one HIV infected children were screened for HAART. Sixty-nine were enrolled and started on HAART. Sixty-six children were started on Triomune and three started on AZT/3TC/NVP or EFV. Median age at enrollment was 5 yrs(1-12 yrs). Median CD4% and viral load at baseline was 9% (0.2-22) and 284,391 copies/mL (150 – 2,276,676). Follow-up at 12, 24, and 36 weeks showed a CD4% and viral load of 20% (1 – 41), 121 copies/mL (59 – 36991); 24% (7 – 44), 141 copies/mL (59 – 80,607); 28% (8 – 58), 190 copies/mL (0 – 140,418), respectively (p<0.0001). Seventy-one percent of children had undetectable viral loads (<400 copies/mL) at 36 weeks. The five children with detectable viral loads at 36 weeks were exposed to single-dose Nevirapine. Adherence to therapy has been 95% in 90% of the children. Side effects include a skin rash in 6% (4/69) and hepatitis in 1% (1/69). Mortality rate is 6% (4/69).
CONCLUSIONS: The use of Triomune in HIV infected children is effective. Triomune therapy led to a significant increase in CD4 count and decrease in viral load after 36 weeks of therapy. Adherence to tablet formulations is better than to syrup formulations. We are still monitoring the effect of single-dose NVP on response to future NVP containing HAART regimens.
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Clinical | WeOa0103 | Linda Barlow-Mosha
Paediatric treatment strategies
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