背景:由于缺乏在儿科环境中使用新药的经验,因此在儿童中管理多药耐药(MDR)HIV感染尤其具有挑战性。在一线治疗失败后,具有优化的抗逆转录病毒背景疗法的二线白蛋白(ABT)被批准用于成人和青少年。本文描述了基于ABT的双重活性抗逆转录病毒治疗方案在患有MDRHIV毒株的儿童中的治疗结果和不良反应。
方法:一名13岁的中国女性患者感染了MDRHIV病毒株,在使用基于ABT的抗逆转录病毒方案治疗12个月后,病毒载量降低(从4.48log10降低至1.73log10),CD4+T细胞增加(从15至308细胞/μl)。患儿未出现与药物相关的不良反应。
结论:本文报道的病例可能表明,基于ABT的抗逆转录病毒疗法可能对患有MDRHIV的儿童有益,并且没有相关毒性。专门管理艾滋病毒的传染病学家应该准备好管理越来越多的患有MDR艾滋病毒的儿童。ABT可能是儿童MDRHIV感染的新治疗选择。
Managing multidrug-resistant (MDR) HIV infections in children is particularly challenging due to the lack of experience with new drugs in the pediatric setting. Second-line albuvirtide (ABT) with an optimized antiretroviral background therapy was approved for adults and adolescents after first-line treatment failure. This paper describes the treatment outcomes and adverse effects of an ABT-based dual-active antiretroviral treatment regimen in a child with MDR HIV strains.
A 13 year-old Chinese female patient infected with MDR HIV strains showed a decrease in viral load (from 4.48 log10 to 1.73 log10) and an increase in CD4 + T cells (from 15 to 308 cells/µl) after 12 months of treatment with an ABT-based antiretroviral regimen. The child showed no relevant drug-related adverse reactions.
The case reported here could suggest that an ABT-based antiretroviral therapy might be beneficial and without relevant toxicity in children with MDR HIV. Infectiologists specializing in managing HIV should be prepared to manage an increasing number of children with MDR HIV. ABT might be a new treatment option for MDR HIV infection in children.