Skip Navigation LinksHome > March 2012 - Volume 31 - Issue 3 > Potent and Sustained Antiviral Response of Raltegravir-based...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31824580e8
HIV Reports

Potent and Sustained Antiviral Response of Raltegravir-based Highly Active Antiretroviral Therapy in HIV Type 1-infected Children and Adolescents

Briz, Verónica PhD*; León-Leal, Juan A. MD; Palladino, Claudia PhD*; Moreno-Perez, David MD; de Ory, Santiago J. BSc; De José, Ma Isabel MD§; González-Tomé, Ma Isabel MD; Martín, César Gavilán MD; Pocheville, Itziar MD**; Ramos, José T. MD††; Leal, Manuel MD‡‡; Muñoz-Fernández, Ma Ángeles PhD, MD*

Collapse Box


Background: There are pediatric patients receiving many highly active antiretroviral therapy (HAART) regimens entailing drug resistance mutations that complicate HAART effective therapies.

Methods: This was a multicenter retrospective study of 19 multidrug-resistant children and adolescents enrolled from July 2007 to October 2009. Patients were nonresponders because no reduction in HIV type 1 (HIV-1) RNA to undetectable levels was observed during their previous antiretroviral treatment history. The long-term effectiveness of raltegravir (RAL)-based salvage therapy was assessed through a longitudinal analysis of immunologic, virologic, and clinical status of the patients.

Results: Median age was 16.0 (15.0–18.0) years. At baseline, median HIV-1 RNA was 10,000 (4.0 log10 copies/mL) (interquartile range [IQR]: 4300–83,000), and median CD4+T-cell count was 329 (18.2% cells/μL) (IQR: 175–452). The backbone regimen included at least 1 fully active drug in 17/19 (89%) patients. Median follow-up with HAART including RAL was 80.1 weeks (IQR: 49.4–96.4): 16/19 (84%) exposed for >120 weeks and 6/19 (32%) >100 weeks. After RAL-based therapy, 4/19 (21%) patients achieved HIV-1 RNA <400 copies and 13/17 (68%) reached HIV-1 RNA <50 copies: 6 (32%) within the first month and 7 (37%) within the first 4 months. CD4+T-cell recovery (70% to 90% of the baseline values) was observed in 17/19 (89%) patients. No deaths, AIDS-defining illnesses, or symptoms of severe intolerance were recorded. Only 2 patients experienced mild-moderate short-term skin rash. Two (11%) patients had sustained and optimum adherence to HAART. No patients showed resistance mutations to RAL after follow-up.

Conclusions: We observed a sustained antiviral response and improved immunologic indices in multidrug-resistant pediatric patients, most of whom had received RAL as part of salvage regimens with at least 1 fully active drugs.

© 2012 by Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.