Because of serious adverse effects, the Food and Drug Administration warns against using lopinavir in infants younger than 42 weeks postconception. However, there is an imperative for early treatment. We report on our use of LPV in 8 premature HIV-infected infants. The median age at initiation was 27 days. Trough values guided dosing. Five infants needed doses above 300 mg/m2. Although no adverse events were noted, lopinavir usage requires caution and careful monitoring.
From the *Department of Pediatrics and Child Health, Tygerberg Children’s Hospital and Stellenbosch University; †Department of Clinical Pharmacology, Groote Schuur Hospital, University of Cape Town; and the ‡Children’s Infectious Diseases Research Unit, Tygerberg Children’s Hospital and Stellenbosch University, Cape Town, South Africa.
Accepted for publication February 14, 2012.
M.F.C. received an honorarium from Abbott in 2010, but has no conflicts of interest to declare. The authors have no other conflicts of interest or funding to disclose.
Address for correspondence: Helena Rabie, FCPaed, MSc ID, Tygerberg Children’s Hospital, Children’s Infectious Diseases Research Unit, Private Bag 19063, Parow Valley 7505, South Africa. Email: firstname.lastname@example.org.