Variable use of therapeutic interventions for children with human immunodeficiency virus type I infection in Europe

S. Bernardi, C. Thorne, M. L. Newell, C. Giaquinto, P. A. Tovo, P. Rossi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Although a range of antiretroviral drugs are available for use in children, the appropriate paediatric regimen remains unclear. In a survey to investigate policies and practices relating to the therapeutic management of children infected by the human immunodeficiency virus (HIV), a postal questionnaire was sent to a named paediatrician in 70 major HIV centres in 13 European countries in early 1998. A total of 64 paediatricians (91%) responded. Pneumocystis carinii pneumonia prophylaxis was found to be routine in all centres, although considerable variation existed regarding the time of starting and stopping therapy. Prophylaxis for fungal infections and recurrent bacterial infections was common, with cytomegalovirus prophylaxis being less frequent. Although most centres (89%) used all five currently available nucleoside analogues (ziduvodine, lamivudine, stavudine, didanosine, zalcitabine), there was considerable variability regarding the availability of protease inhibitors. Most respondents delayed initiation of antiretroviral therapy until evidence of disease progression was apparent. The initial prescription of 38% of clinicians was triple therapy and that of 57% prescribed double therapy. Policies varied regarding the modification to regimens in response to disease progression and emergence of side effects and drug resistance. Clinical practice was informed by a number of sources, including centre-specific and national guidelines. Most respondents affirmed the need for European guidelines. Conclusion: Approaches to the therapeutic management of paediatric human immunodeficiency virus infection differ across Europe.

Original languageEnglish
Pages (from-to)170-175
Number of pages6
JournalEuropean Journal of Pediatrics
Volume159
Issue number3
Publication statusPublished - 2000

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Therapeutic Uses
Virus Diseases
HIV
Disease Progression
Therapeutics
Zalcitabine
Guidelines
Pediatrics
Stavudine
Didanosine
Pneumocystis Pneumonia
Lamivudine
Mycoses
Protease Inhibitors
Drug-Related Side Effects and Adverse Reactions
Cytomegalovirus
Nucleosides
Bacterial Infections
Drug Resistance
Prescriptions

Keywords

  • Antiretroviral drug therapy
  • Human immunodeficiency virus
  • Management
  • Prophylactic drug therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Variable use of therapeutic interventions for children with human immunodeficiency virus type I infection in Europe. / Bernardi, S.; Thorne, C.; Newell, M. L.; Giaquinto, C.; Tovo, P. A.; Rossi, P.

In: European Journal of Pediatrics, Vol. 159, No. 3, 2000, p. 170-175.

Research output: Contribution to journalArticle

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