Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Management of Medication Toxicity or Intolerance

CNS Toxicity

Last Updated: May 22, 2018; Last Reviewed: May 22, 2018

References

  1. Food and Drug Association. FDA Drug Safety Communication: Serious health problems seen in premature babies given Kaletra (lopinavir/ritonavir) oral solution. 2011. Available at http://www.fda.gov/Drugs/DrugSafety/ucm246002.htm.
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  13. van Dijk JH, Sutcliffe CG, Hamangaba F, Bositis C, Watson DC, Moss WJ. Effectiveness of efavirenz-based regimens in young HIV-infected children treated for tuberculosis: a treatment option for resource-limited settings. PLoS One. 2013;8(1):e55111. Available at http://www.ncbi.nlm.nih.gov/pubmed/23372824.
  14. Cohen CJ, Molina JM, Cassetti I, et al. Week 96 efficacy and safety of rilpivirine in treatment-naive, HIV-1 patients in two Phase III randomized trials. AIDS. 2013;27(6):939-950. Available at http://www.ncbi.nlm.nih.gov/pubmed/23211772.
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  17. Mollan KR, Smurzynski M, Eron JJ, et al. Association between efavirenz as initial therapy for HIV-1 infection and increased risk for suicidal ideation or attempted or completed suicide: an analysis of trial data. Ann Intern Med. 2014;161(1):1-10. Available at http://www.ncbi.nlm.nih.gov/pubmed/24979445.
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  19. Napoli AA, Wood JJ, Coumbis JJ, Soitkar AM, Seekins DW, Tilson HH. No evident association between efavirenz use and suicidality was identified from a disproportionality analysis using the FAERS database. J Int AIDS Soc. 2014;17:19214. Available at http://www.ncbi.nlm.nih.gov/pubmed/25192857.
  20. Leutscher PD, Stecher C, Storgaard M, Larsen CS. Discontinuation of efavirenz therapy in HIV patients due to neuropsychiatric adverse effects. Scand J Infect Dis. 2013;45(8):645-651. Available at http://www.ncbi.nlm.nih.gov/pubmed/23427878.
  21. Group ES, Puls R, Amin J, et al. Efficacy of 400 mg efavirenz versus standard 600 mg dose in HIV-infected, antiretroviral-naive adults (ENCORE1): a randomised, double-blind, placebo-controlled, non-inferiority trial. Lancet. 2014;383(9927):1474-1482. Available at http://www.ncbi.nlm.nih.gov/pubmed/24522178.
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  31. Pinillos F, Dandara C, Swart M, et al. Case report: Severe central nervous system manifestations associated with aberrant efavirenz metabolism in children: the role of CYP2B6 genetic variation. BMC Infect Dis. 2016;16:56. Available at http://www.ncbi.nlm.nih.gov/pubmed/26831894.
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  35. Bracchi M, Pagani N, et al. Multicentre open-label pilot study of switching from efavirenz to dolutegravir for central nervous system (CNS) toxicity. Abstract # P209. Presented at: HIV Drug Therapy Conference. 2016. Glasgow, Scotland, UK.
  36. Quercia R, Roberts J. Psychiatric adverse events from the DTG ART-naive phase 3 clinical trials. Abstract # P210. Presented at: HIV Drug Therapy Conference. 2016. Glasgow, Scotland, UK.
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  39. Fettiplace A, Stainsby C, Winston A, et al. Psychiatric symptoms in patients receiving dolutegravir. J Acquir Immune Defic Syndr. 2017;74(4):423-431. Available at https://www.ncbi.nlm.nih.gov/pubmed/27984559.
  40. Viswanathan P, Baro E, Soon G, Sherwat A, Struble KA. Neuropsychiatric adverse events associated with integrase strand transfer inhibitors. Presented at: Conference on Retroviruses and Opportunistic Infections. 2017. Seattle, WA.
  41. Todd S, Rafferty P, Walker E, et al. Early clinical experience of dolutegravir in an HIV cohort in a larger teaching hospital. Int J STD AIDS. 2017:956462416688127. Available at https://www.ncbi.nlm.nih.gov/pubmed/28118801.
  42. Variava E, Sigauke FR, Norman J, et al. Brief Report: late efavirenz-induced ataxia and encephalopathy: a case series. J Acquir Immune Defic Syndr. 2017;75(5):577-579. Available at https://www.ncbi.nlm.nih.gov/pubmed/28520619.
  43. Briand C, Dollfus C, Faye A, et al. Efficacy and tolerance of dolutegravir-based combined ART in perinatally HIV-1-infected adolescents: a French multicentre retrospective study. J Antimicrob Chemother. 2017;72(3):837-843. Available at https://www.ncbi.nlm.nih.gov/pubmed/27999017.

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