ABSTRACT
The use of atazanavir (ATV) in adolescents infected with human immunodeficiency virus was analyzed in this study. ATV morning plasma concentrations were determined during regular visits to the outpatient department. Results showed that bilirubin levels were higher among patients with higher ATV plasma concentrations (p = .018). Monitoring plasma levels of ATV could avoid toxicity in these patients.
Subject(s)
Bilirubin/blood , HIV Infections/blood , HIV Infections/drug therapy , Oligopeptides/administration & dosage , Oligopeptides/blood , Pyridines/administration & dosage , Pyridines/blood , Adolescent , Adolescent Health Services , Anti-HIV Agents/administration & dosage , Atazanavir Sulfate , Child , Drug Administration Schedule , Drug Monitoring , Female , Humans , Hyperbilirubinemia/prevention & control , Male , SpainABSTRACT
Introducción Los estudios farmacológicos realizados demuestran una relación entre la concentración plasmática de antirretrovirales (ARV) y su toxicidad y actividad antiviral. Sin embargo, en niños con infección por el virus de la inmunodeficiencia humana (VIH), los datos farmacocinéticos y farmacodinámicos son heterogéneos y limitados. Pretendemos analizar los niveles de fármacos ARV en la práctica clínica, en niños infectados por VIH y su influencia en la efectividad terapéutica. Métodos Estudio observacional, prospectivo y multicéntrico, que incluye niños con infeccion por VIH, controlados en 5 hospitales terciarios entre marzo de 2006 y junio de 2008. Se determinó la concentración plasmática de ARV en el momento predosis y se analizó la relación con diferentes variables clínicas y analíticas. Resultados Se incluyó un total de 129 pacientes. El 41,3% presentaba niveles plasmáticos fuera del rango establecido. No se hallaron diferencias analíticas en función del género. Los menores de un año presentaban concentraciones infraterapéuticas y carga viral elevada, de modo más frecuente que el resto de los niños. Conclusión Las concentraciones plasmáticas de ARV son infraterapéuticas con mayor frecuencia en los menores de un año. Este hallazgo se relaciona con mayor fallo viral y supone un reto importante en esta población, que requiere un tratamiento a muy largo plazo (AU)
Introduction Pharmacologic studies have shown a relationship between plasma antiretroviral levels and toxicity/viral activity. Nevertheless, pharmacokinetic and pharmacodynamic data are inconsistent and limited in HIV-infected children. An analysis was performed of plasma antiretroviral concentrations in clinical practice and their influence on therapy efficacy in HIV-infected children. Methods Observational, prospective, multicenter study, including HIV-infected children followed up at 5 reference hospitals between March 2006 and June 2008. Pre-dose plasma antiretroviral levels were determined and the relationships with various clinical and analytical variables were investigated. Results A total of 129 patients were included, and 41.3% had antiretroviral plasma levels outside the established range. No differences were found between sexes. Children younger than 1 year had a higher rate of suboptimal levels and higher viral load than the remaining children. Conclusion Antiretroviral plasma concentrations are more frequently suboptimal in children younger than 1 year. This finding is related with greater viral failure and implies a considerable challenge in this population, which requires very long-term treatment (AU)
Subject(s)
Humans , Male , Female , Child , HIV Infections/blood , Age Factors , HIV Infections/drug therapy , Prospective Studies , Sex FactorsABSTRACT
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