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Journal of Virology, October 2004, p. 11272-11275, Vol. 78, No. 20
0022-538X/04/$08.00+0     DOI: 10.1128/JVI.78.20.11272-11275.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Rapid Human Immunodeficiency Virus Decay in Highly Active Antiretroviral Therapy (HAART)-Experienced Children after Starting Mega-HAART

Nottasorn Plipat,1 Ping K. Ruan,2 Terence Fenton,2 and Ram Yogev3*

Division of Infectious Diseases, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand,1 Statistical and Data Analysis Center, Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts,2 and Division of Infectious Diseases, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Medical School, Chicago, Illinois3

Received 5 March 2004/ Accepted 10 June 2004

Increasing numbers of patients are treated with mega-highly active antiretroviral therapy (HAART), or multiple-combination antiretroviral therapy, in an attempt to overcome the viral resistance that has contributed to treatment failure. Studies of human immunodeficiency virus (HIV) viral dynamics are used to quantify the potency of a given regimen. While mega-HAART is expected to provide potent therapy, its potency among heavily experienced HIV-infected children who have failed previous treatment is untested. HIV dynamics studies performed in children have provided minimal information on viral dynamics during mega-HAART. The present study estimates first- and second-phase viral dynamics in six children on mega-HAART, following failure of combination therapy. The first phase of viral decay was rapid, relative to rates reported in previous pediatric studies (median {delta} = 0.778d–1, range = 0.583 to 1.088, half-life 1 [t11/2] = 0.894d), while the second phase revealed results similar to those of previous studies (median µ = 0.026d–1, range = –0.005 to 0.206, t21/2 = 9.316d). This indicates that mega-HAART can provide potent therapy among heavily experienced pediatric patients.

* Corresponding author. Mailing address: Division of Infectious Diseases, Section of Pediatric, Adolescent, and Maternal HIV Infection, Children's Memorial Hospital, 2300 Children's Plaza, Box 155, Chicago, IL 60614. Phone: (773) 880-4757. Fax: (773) 880-3208. E-mail: ryogev{at}childrensmemorial.org.

Journal of Virology, October 2004, p. 11272-11275, Vol. 78, No. 20
0022-538X/04/$08.00+0     DOI: 10.1128/JVI.78.20.11272-11275.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.





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