RESUMEN
The present study evaluated the incidence and risk factors that correlated with the development of non-nucleoside reverse transcriptase inhibitor (NNRTI) related rash in 69 Thai children followed prospectively. The overall incidence of NNRTI-related rash was 16% (22% for NVP and 4% for EFV rash). The only significant predictive factor that correlated with the development of NNRTI-related rash in a multivariate logistic regression model was a CD4% decrease at week 12.
Asunto(s)
Fármacos Anti-VIH/efectos adversos , Antirretrovirales/efectos adversos , Recuento de Linfocito CD4 , Niño , Preescolar , Exantema/inducido químicamente , Femenino , Transcriptasa Inversa del VIH/antagonistas & inhibidores , Humanos , Masculino , Estudios Prospectivos , Inhibidores de la Transcriptasa Inversa/efectos adversos , Factores de Riesgo , Tailandia/epidemiologíaRESUMEN
BACKGROUND: Indinavir (IDV) is the protease inhibitor (PI) used most often in resource-limited countries. The present study aimed to determine the prevalence of IDV-associated renal complications as well as their clinical characteristics. MATERIAL AND METHOD: The authors reviewed all patients participating in cohorts of indinavir-containing regimens at the HIV-NAT research center during the period of indinavir treatment. Patients who had pre-existing renal diseases were excluded. Renal toxicities included presence of urologic symptoms, nephrolithiasis, abnormal urine sediments, crystalluria and loss of renal function. Radiological studies of KUB system were reviewed as well. RESULTS: Two-hundred and four patients treated with IDV were included. Median (IQR) follow up period was 216 (150-312) weeks. One hundred and eighty patients were treated with ritonavir-boosted regimens at some point, and 24 patients were treated only with unboosted regimens. Leukocyturia (51.9%) was the most common finding of IDV-associated renal complications. Thirty-five percent of patients had urologic symptoms such as flank pain or dysuria. Almost half of the patients had significant loss of renal function that was associated with prolonged use of IDV The most common radiological finding was nephrolithiasis. Less common, but of greater clinical importance, are nephrocalcinosis or renal atrophy. CONCLUSION: A high prevalence of IRC was found in Thai HIV-infected patients. As long as no other cost-effective boosted PI regimens are available, strategies to prevent irreversible loss of renal function are warranted.