Antiretroviral therapy in HIV-1 infected children

Highly active antiretroviral therapy is beyond reach of most HIV-infected children in developing countries. There is paucity of data on more affordable regimens such as ones based on nevirapine and 2 nucleoside reverse transcriptase inhibitors. We report our experience with the use of antiretroviral therapy in children with HIV-1 infection at a tertiary care hospital in north India. The study subjects were HIV-1 infected children, who were receiving 3-drug antiretroviral therapy for a period of three or more months. The children were regularly followed up for any complications, changes in anthropometry, and changes in CD4 counts. The mean age of children at diagnosis (n=26; 22 boys) was 68.5 +/- 33.4 months. These children were followed up for a mean of 19.7 +/- 18.7 months. Twenty four children received nevirapine based regimen. There was statistically significant improvement in weight for height and body mass index on follow lip. The mean CD4 count changed from baseline (n=24) of 584.3 +/- 685.9/mm(3) to 614.4 +/- 455.7/mm(3) (n= 15) at last follow up. One child developed minor skin rash in the initial two weeks of starting nevirapine. One child developed pancreatitis. We conclude that adininistration of nevirapine based ART for HIV- I infected children is feasible in resource poor setting. There is improvement in growth parameters with use of this therapy.