Document Detail

Effect of combination antiretroviral therapy on cerebrospinal fluid HIV RNA, HIV resistance, and clinical manifestations of encephalopathy.
MedLine Citation:
PMID:  12091849     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study evaluated the effect of treatment with abacavir/lamivudine/zidovudine versus lamivudine/zidovudine on cerebrospinal fluid (CSF) human immunodeficiency virus (HIV) RNA and clinical manifestations of HIV encephalopathy in children.
STUDY DESIGN: HIV-infected children 7 months to 10 years of age (n = 23) were studied. CSF and plasma were obtained at baseline and weeks 8, 16, and 48. Genotype analysis of HIV was attempted at baseline and week 48. Neurologic evaluations were performed at baseline and weeks 16, 32, and 48.
RESULTS: At baseline, 83% of children had >2.00 log(10) copies/mL HIV RNA in CSF, but only 10% had HIV RNA measurable at week 48. Among children in whom paired genotyping of HIV was possible, 8 of 11 had identical patterns in both CSF and plasma at baseline, whereas at week 48, only 1 of 9 children had similar patterns. Neurologic abnormalities were observed in 83% of children at baseline but only 35% of children at week 48 (P =.004), suggesting a benefit of treatment.
CONCLUSIONS: Antiretroviral therapy was associated with a decline in CSF HIV RNA and an improvement in neurologic status. The development of genotypic mutations was different in CSF and plasma, suggesting discordant viral evolution. These results suggest that antiretroviral treatment in children should include agents with activity in the CNS.
Cynthia McCoig; Maria Mercedes Castrejón; Elizabeth Castaño; Onix De Suman; Carmen Báez; Wilfrido Redondo; Daniel McClernon; Susan Danehower; E Randall Lanier; Carol Richardson; Amy Keller; Seth Hetherington; Xavier Sáez-Llorens; Octavio Ramilo
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  141     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-01     Completed Date:  2002-08-07     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-44     Citation Subset:  AIM; IM    
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75390-9063, USA.
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MeSH Terms
AIDS Dementia Complex / classification,  diagnosis,  drug therapy*
Anti-HIV Agents / pharmacology,  therapeutic use*
Child, Preschool
Dideoxynucleosides / pharmacology,  therapeutic use*
Drug Resistance, Viral
Drug Therapy, Combination
HIV-1* / drug effects,  genetics
Lamivudine / pharmacology,  therapeutic use*
RNA, Viral / blood,  cerebrospinal fluid
Statistics, Nonparametric
Viral Load
Zidovudine / pharmacology,  therapeutic use*
Reg. No./Substance:
0/Anti-HIV Agents; 0/Dideoxynucleosides; 0/RNA, Viral; 134678-17-4/Lamivudine; 30516-87-1/Zidovudine; WR2TIP26VS/abacavir

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