Document 0465
 DOCN  M9550465
 TI    HIV therapy advances. Pediatric antiretroviral choices.
 DT    9505
 AU    Spector SA; Department of Pediatrics, University of California, San
       Diego, La; Jolla 92093-0672.
 SO    AIDS. 1994 Sep;8 Suppl 3:S15-8. Unique Identifier : AIDSLINE
       MED/95142948
 AB    BACKGROUND: Zidovudine is the initial treatment of choice in
       HIV-infected children. Zalcitabine or didanosine may be used in children
       who do not respond adequately or who are intolerant of zidovudine.
       Several studies of the latter agents are reviewed. MONOTHERAPY STUDIES:
       Zalcitabine at 0.005 or 0.01 mg/kg three times a day was associated with
       stabilization of growth and a decline in p24 antigen levels in more than
       50% of treated children. In a dose-ranging study of didanosine, 30% of
       children showed an increase in CD4 cell counts and gained weight. There
       was a correlation between the plasma didanosine concentration and an
       improvement in IQ (Intelligence Quotient) and p24 status. STUDIES ON
       COMBINATION THERAPY: In a 12-18 month trial of zidovudine/zalcitabine in
       13 children, most gained weight and more than half showed improved CD4
       cell counts. The combination of various doses of didanosine with
       zidovudine was associated with a reduction in viral titer, a significant
       increase in CD4 cell counts and a trend towards increased weight in many
       children. STUDY IN MOTHER TO INFANT TRANSMISSION: Zidovudine or placebo
       was administered to women throughout pregnancy and during labor and to
       their new-born infants up to 6 weeks of age. The infection rate for the
       zidovudine-treated group was 8.3% compared with 25.5% for the placebo
       group (P = 0.000056). CONCLUSION: Zalcitabine and didanosine are useful
       drugs in the treatment of HIV-infected children. Zidovudine is
       associated with a reduced rate of mother to infant viral transmission.
 DE    Body Weight  Clinical Trials  Comparative Study  Didanosine/*THERAPEUTIC
       USE  Disease Transmission, Vertical/PREVENTION & CONTROL  Female  Growth
       Human  HIV Infections/*DRUG THERAPY/*PREVENTION & CONTROL/TRANSMISSION
       Infant, Newborn  Pregnancy  Pregnancy Complications, Infectious/VIROLOGY
       Treatment Failure  Zalcitabine/*THERAPEUTIC USE  Zidovudine/*THERAPEUTIC
       USE  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).