Antiretroviral drug toxicity in human immunodeficiency virus infected children

• Published in: Anales de pediatría (Barcelona, Spain : 2003) Spain : 2003), 2008-05, Vol.68 (5), p.425
• Main Authors: Núñez Cuadros, E, Mellado Peña, M J, Rivera Cuello, M, Penim Fernández, M, Piñeiro Pérez, R, García-Hortelano, M, Cilleruelo Ortega, M J, Villota Arrieta, J, Martín-Fontelos, P
• Format: Article
• Language: Spanish
• Subjects: Acidosis, Lactic - chemically induced; Adolescent; Anti-Retroviral Agents - adverse effects; Bone Diseases, Metabolic - chemically induced; Bone Diseases, Metabolic - diagnostic imaging; Child; Child, Preschool; Female; HIV Infections - drug therapy; Humans; Hyperlipidemias - chemically induced; Hypertension - chemically induced; Insulin Resistance; Lipodystrophy - chemically induced; Metabolic Syndrome - chemically induced; Radiography; Zidovudine - adverse effects
• ISSN: 1695-4033

Paediatric Human Immunodeficiency Virus infection (HIV) nowadays is a chronic disease with an excellent long term prognosis, but lifelong combined antiretroviral treatment is required. However, an improved quality of life in this population is limited by adverse drug effects. The highest risk of treatment toxicity is developing a complete metabolic syndrome including: Hyperlipemia, lipodystrophy, insulin resistance, lactic acidosis, osteopenia, hypertension, and specific system and organ toxicity, such as the kidney, liver, CNS or bone marrow. The risk of cardiovascular disease adult life and also definitive bone mass damage are the most significant metabolic costs that have to paid for increased survival. Most of these toxicities were able to be adequately treated but, pharmacological interferences, patient intolerance and the high number of drugs are the problems that limit the adherence to treatment, which is essential for a good therapeutical efficacy. In this article, we present four HIV paediatric patients who presented with almost the whole range of metabolic toxicities, and a practical overview of therapeutical management.