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Abstract
Potency of efavirenz as part of a first-line antiretroviral therapy (ART) regimen in antiretroviral naïve children in a public hospital in Soweto, South Africa
T M Meyers1, H J A Moultrie2, S Mtshizana3, H Gous3
1Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa; 2School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; 3Wits Paediatric HIV Working Group, Johannesburg, South Africa
Background: With the imminent roll-out of ART in South Africa, non-nucleoside reverse transcriptase inhibitors (NNRTIs) will be used in first-line regimens. There is little published data regarding efficacy or tolerability of efavirenz when used in protease inhibitor sparing regimens in children. Methods: Funds were raised to support treatment for children attending the paediatric HIV outpatient clinic at Chris Hani Baragwanath Hospital in Soweto. Children requiring treatment were selected and commenced on treatment as part of an operational research project. Viral load (VL) and CD4 counts were performed at baseline and the children started on efavirenz, D4T and 3TC. HIV-1 RNA plasma levels and CD4 counts are being monitored at 3 monthly intervals. Results: To date, 22 antiretroviral naive children have been enrolled onto this program. Enrolment is ongoing. Children enrolled had generally advanced disease with 16 (73%) categorised as having Category B and 6 (27%) as Category C disease. The mean age at start of treatment was 99 months, with a range of 41 to 145 months. Baseline values (median) of VL and CD4 counts (means) were 356500 copies/ml and 298 cells/mm3 (CD4%=10.1%) respectively. No patients have changed regimens or been lost to follow up. The 11 children who have completed 12 weeks of treatment all achieved VL < 400copies/ml (mean 3.46 log decrease). The CD4 counts had a mean increase of 143cells/mm3(p= 0.03) while the mean CD4% increasing by 7.1% (p=0.003) at 12 weeks. No serious side-effects have been noted. Conclusions: Efavirenz as part of a first-line regimen appears to be potent in treatment of ART-naïve children in this cohort. This is encouraging as this drug has been earmarked as part of the initial treatment for children and adults in the South African Government's roll-out of ART plan.
The XV International AIDS Conference
Abstract no.
TuPeB4428
Suggested Citation
"T M Meyers, , et al.
Potency of efavirenz as part of a first-line antiretroviral therapy (ART) regimen in antiretroviral naïve children in a public hospital in Soweto, South Africa.
Poster Exhibition:
The XV International AIDS Conference:
Abstract no.
TuPeB4428"
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