Are lopinavir and efavirenz serum concentrations in HIV-infected children in the therapeutic range in clinical practice?. (May 2014)

• Record Type: Journal Article
• Authors: Bibra, Mirjam von; Rosenkranz, Bernd; Pretorius, Erina; Rabie, Helena; Edson, Claire; Lenker, Ulrike; Cotton, Mark; Klinker, Hartwig
• Is Part Of: Paediatrics and international child health. Volume 34:Number 2(2014:May)
• Page Start: 138
• Page End: 141
• Publication Date: 2014-05
• Subjects: Pediatrics -- Developing countries -- Periodicals; Children -- Health and hygiene -- Developing countries -- Periodicals; Children -- Diseases -- Developing countries -- Periodicals; 618.920009172405
• DOI: 10.1179/2046905513Y.0000000090
• Languages: English
• ISSNs: 2046-9047

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>In antiretroviral treatment the role of therapeutic drug monitoring via measurement of serum levels remains unclear, especially in children.</p> </sec> <sec> <title>Aim:</title> <p>To quantify exposure to LPV and EFV in children receiving therapy in a routine clinical setting in order to identify risk factors associated with inadequate drug exposure.</p> </sec> <sec> <title>Method:</title> <p>A prospective study was conducted in a routine clinical setting in Tygerberg Children's Hospital, South Africa. A total of 53 random serum levels were analyzed. Serum concentrations were determined by an established high-performance liquid chromatography method.</p> </sec> <sec> <title>Results:</title> <p>Of 53 HIV-infected children treated with lopinavir (<italic>n</italic> = 29, median age 1·83 y) or efavirenz (<italic>n</italic> = 24, median age 9·3 years), 12 showed serum levels outside the therapeutic range (efavirenz) or below Cmin (lopinavir). Low bodyweight, rifampicin co-treatment, and significant comorbidity were potential risk factors for inadequate drug exposure.</p> </sec> <sec> <title>Conclusion:</title> <p>These findings, together with previous studies, indicate that therapeutic drug monitoring can improve the management of antiretroviral therapy in children at risk.</p> </sec> </abstract>