Nutritional and immune effects of efavirenz and indinavir regimen in HIV horizontally infected children

Assessment of combined antiretroviral therapy with efavirenz (EFV) and indinavir (IDV) effects on nutritional and immune status in HIV positive children. Prospective opened study. HIV positive children (n = 41, 8-12 years old), previously treated with 1 to 2 INRT were followed up for nutritional and immune responses at enrolment in a new antiretroviral regimen including EFV and IDV. The patients were divided by immune deficiency into three groups: A (CD4 = 201-500/mm super(3)), B (CD4 = 101-200/mm super(3)), and C (CD < 100/mm super(3)). Nutritional counselling and intervention were performed in all cases. Weight/Height Z score (WHZ) was determined as significant individual marker for nutritional response, whereas CD4 count was used as marker for evaluating the immune response. Anthropological indices were calculated using EpiNut Anthropometry of EpiInfo software; multivariable linear statistics were performed using Statistica 7.0. Results at week 20 show an uniformly distributed nutritional response: WHZ versus controls (i.e. NCHS reference and standard values) present an increase of 0.3 SD (P < 0.01). The immune response is augmented differently, with greatest increments in children with initial low CD4 count, and an overall increase in absolute numbers of 180 (50-320), P < 0.001. EFV and IDV combined antiretroviral therapy determined at the studied group of HIV infected children both nutritional and immune status improvement, regardless the initial severity of immunodeficiency and/or nutritional status.