Clinical, virologic and immunologic responses of children with advanced human immunodeficiency virus type 1 disease treated with protease inhibitors.
Clinical, virologic and immunologic responses of children with advanced human immunodeficiency virus type 1 disease treated with protease inhibitors.
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用蛋白酶抑制剂治疗患有晚期人类免疫缺陷病毒 1 型疾病的儿童的临床、病毒学和免疫学反应。
DOI：
10.1097/00006454-199710000-00013
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Frenkel,LM
中科院分区：
文献类型：
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作者：
Melvin,AJ;Mohan,KM;Arcuino,LA;Edelstein,RE;Frenkel,LM
目的：确定包括蛋白酶抑制剂在内的联合抗逆转录病毒治疗的效果（PI联合治疗）在晚期HIV-1疾病儿童中的应用。研究设计。在开始PI联合治疗后，对HIV-1血浆RNA、淋巴细胞亚群、迟发型超敏反应和体格生长进行观察性研究。结果。在9名儿童中，HIV-1血浆RNA中位数下降1.7 log 10（平均值，1.57;范围，0.7 - 2.2），CD 4细胞增加中位数为499（平均值，528;范围，9 - 1088）个细胞/μl。RNA的反弹，与耐药性的PI的发展，发生在三个主题。六个孩子中有三个不再是无反应性的，所有九个孩子都达到了正常的体重增长速度。利托那韦是耐受性良好，尽管它的苦味，但是，四个五个孩子用茚地那韦治疗开发肾脏并发症.Conclusions.PI联合治疗晚期HIV-1疾病的儿童与HIV-1 RNA的减少，改善免疫措施和正常或更好的体重增加。值得关注的是，在三分之一的患者中观察到与PI耐药相关的血浆HIV-1反弹。这强调了需要更大规模的研究来确定在儿童中具有长期疗效的最佳含PI方案。
Objective.To determine the effects of combination antiretroviral therapy including a protease inhibitor (PI combination therapy) in children with advanced HIV-1 disease.Study design.An observational study of HIV-1 plasma RNA, lymphocyte subsets, delayed type hypersensitivity and physical growth after initiation of PI combination therapy.Results.In nine children the median HIV-1 plasma RNA decreased 1.7 log 10 (mean, 1.57; range, 0.7 to 2.2) following PI combination therapy and CD4 cells increased a median of 499 (mean, 528; range, 9 to 1088) cells/μl. A rebound of RNA, associated with the development of resistance to the PI, occurred in three subjects. Three of six children were no longer anergic and all nine achieved normal weight-growth velocities. Ritonavir was well-tolerated, despite its bitter taste; however, four of five children treated with indinavir developed renal complications.Conclusions.PI combination therapy in children with advanced HIV-1 disease was associated with a decrease in HIV-1 RNA, improved immunologic measures and normal or better weight gain. Of concern was the rebound in plasma HIV-1 associated with resistance to the PI observed in onethird of patients. This emphasizes the need for larger studies to define optimal PI containing regimens with long term efficacy in children.