Seventh International Congress on Drug Therapy in HIV Infection Glasgow, UK - 14-17 November 2004

Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL11.1

Carlo Giaquinto
Department of Paediatrics, University of Padova, Padova, Italy

Children differ from adults in the natural history of HIV-1 infection, immunology, virology patterns of drug tocixity and adherence related issues.

The response of the immune system is very specific and different in adults and children: children have an active thymus and a greater capacity than adults to regenerate their immune systems after starting ART. This has important implications on the immunoresponse after treatment interruption. Viralo laod is very high at the time of delivery and naturally decline by 2 years of age even without therapy.

The pattern of drug toxicity is different in adults and paediatric patients (with also difference between infants and children) being the latter still growing and not yet fully developed. Lypodistrophy syndrome is present in about 30% (but hyper lipidemiaof is rare) of treated children and seems to be related to puberty . Immunereconstitution syndrome is rare in paediatrics and might be related to the low number of memory cells as compared to adults.

In the first year of life enzymatic pathways are in development and drug metabolism is age dependent. PK studies in infants and children are essential to define the best dosing and to evaluate in details the mechanisms of drug toxicity.

Drug adherence is a challenging issue in paediatrics (especially adolescents) and the choice of ARTs must consider the age of the child, the papatability of drug formulation and the numebr of pills per day. In addition issues such as diagnosis disclosure and social situation need also to be addressed.

SESSION 11: PAEDIATRIC INFECTION

2004-11-14
PL11.1

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