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Variable use of therapeutic interventions for children with human immunodeficiency virus type 1 infection in Europe.

Abstract：

UNLABELLED: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.

journal_name

Eur J Pediatr

journal_title

European journal of pediatrics

authors

Bernardi S,Thorne C,Newell ML,Giaquinto C,Tovo PA,Rossi P

doi

10.1007/s004310050045

keywords:

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

170-5

issue

3

eissn

0340-6199

issn

1432-1076

pii

01590170.431

journal_volume

159

pub_type

杂志文章,多中心研究

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