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Switch from Ritonavir to Indinavir in Combination Therapy for Children with HIV
Protease inhibitors are an effective component of combination antiretroviral treatment for children infected with HIV, but tolerance or toxicity issues sometimes require an alternative therapeutic strategy.
HIV-infected children aged 2-17 years received combination therapy with either stavudine (d4T; Zerit) plus ritonavir (Norvir) or with zidovudine (AZT; Retrovir), lamivudine (3TC; Epivir), and ritonavir as part of a randomized clinical trial. Twenty-one months after the start of the trial, ritonavir in capsule formulation became unavailable.
The treatment regimen for 25 children was switched from ritonavir capsules to indinavir (Crixivan) capsules (500 mg/m(2) every 8 h). The other study drugs remained unchanged.
A matched-pairs analysis was performed to compare the results for these 25 children with the results for 25 matched children whose treatment regimen continued to include ritonavir (in liquid formulation).
There were no significant differences in the percentage of children with an HIV RNA load of <or=200 copies/mL between the group receiving indinavir and the matched group receiving ritonavir (52% vs. 68%, at the start of indinavir treatment; 42% vs. 52%, at week 12; and 50% vs. 56%, at week 24).
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