The efficacy and tolerance of antiretroviral combination containing efavirenz (stocrin) in HIV-infected children

In Romania were registered over 10 000 HIV-infected children. It means almost 50% of HIV-infected children of Europe. About 70% are living, and 30% of them receive HAART. National guidelines are available to initiate or to switch the therapy. In our day clinic we have registered more than 700 HIV-infected children. We started to administer efavirenz (EFV) in combination in 40 children for 48 weeks as follows: 1) EFV + indinavir (16 cases); 2) EFV + IDV + NRT1 (15 cases); 3) EFV + 2NRTIs (9 cases). There were naive patients in the group 1, and experienced for NRTIs in the other two groups. The HIV infection in our children had various stages (A sub(1) - 14; B sub(2) - 10; B sub(3) - 14, C sub(3) - 2). We monitored the therapy by: CD4 cell count, viral load, hematological and biochemical tests. Clinically we monitored the opportunistic infections, associated illness, oncology diseases, adverse reactions and somatic parameters. We observed just one case of lipodystrophy. No case of glycemia modification. We have just three cases of failure in the first group, four cases in the second group and one case in the third group. It means 20% of all 40 cases. Failure definition was the increasing of the copies after 3 months of treatment. The median of the CD4 lymphocytes increased over 50 cell/ml after 6 months in 80% of cases and decreased in 10%. All combinations of EFV have similar and very good efficacy in naive and experienced HIV-infected children. EFV was very well tolerated in these combinations. The study will continue for all the children who experienced good efficacy of EFV in combination offering very good quality of surviving.