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Antiretroviral Regimens Containing a Single Protease Inhibitor Increase Risk of Virologic Failure in Young HIV-infected Children

Walters, Elisabetta FCPaed, MMed*; Reichmuth, Kirsten MBChB; Dramowski, Angela FCPaed, MMed; Marais, Ben J. PhD§; Cotton, Mark F. FCPaed, PhD; Rabie, Helena FCPaed, MMed, MSc

Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e318279c800
HIV Reports
Abstract

Rifampin-based tuberculosis treatment can cause subtherapeutic concentrations of protease inhibitors and virologic failure in children receiving antiretroviral therapy. Among 217 children on antiretroviral therapy, tuberculosis cotreatment (in 78) was associated with virologic failure. Ritonavir-based single protease inhibitor antiretroviral therapy regimen predicted virologic failure (adjusted odds ratio 3.7, 95% confidence interval 1.5–8.9, P = 0.004) on multivariate analysis.

Author Information

From the *Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University; Department of Paediatrics, University of Cape Town; Department of Paediatrics and Child Health, Tygerberg Children’s Hospital, Stellenbosch University, Cape Town, South Africa; and §Department of Paediatrics and Child Health, Sydney Institute for Emerging Infections and Biosecurity, The Children’s Hospital at Westmead, University of Sydney, Sydney, Australia.

Accepted for publication October17, 2012.

E.W. received support from the Faculty of Medicine and Health Sciences at Stellenbosch University (employing institution) for travel related to this work in 2011 (3rd Pediatric HIV Workshop in Rome, Italy). The authors have no other funding or conflicts of interest to disclose.

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Address for correspondence: Elisabetta Walters, FCPaed, MMed, Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, P. O. Box 19063, Tygerberg 7505, Cape Town, South Africa. E-mail: ewal@sun.ac.za.

© 2013 Lippincott Williams & Wilkins, Inc.