Age-dependent pharmacokinetics of lamivudine in HIV-infected children

The recommended dose of lamivudine in children is higher when compared with adults: 4 mg/kg vs similar to 2mg/kg (150 mg) and administered twice a day. Limited data are available to demonstrate that this increased dose results in adequate exposure to lamivudine in children with human immunodeficiency virus (HIV) infection. Data were selected from children who were using lamivudine for at least 2 weeks before a full pharmacokinetic (PK) study was conducted. Lamivudine PK parameters were significantly related to age. The age of 6 years appeared to be a cutoff for a change in PK parameters of lamivudine, with children < 6 years of age (n = 17) having a median area under the curve 43% lower and a median peak plasma concentration 47% lower (both P < 0.001) than older children (n = 34). In conclusion, further investigation of the relationship between decreased lamivudine exposure and treatment outcome and long-term resistance development in younger children with HIV infection is warranted.