Efavirenz-based regimen in children with TB/HIV appears beneficial
WASHINGTON — Researchers observed significant improvements in virologic, immunologic and clinical outcomes among children with HIV who received treatment for tuberculosis and were also receiving an efavirenz-based regimen for HIV treatment, according to data presented this week at the XIX International AIDS Conference.
As options are limited for ART in children with HIV/TB coinfection in resource-limited settings, researchers from various institutions set out to assess the treatment outcomes of an efavirenz (EFV) regimen among a cohort of young children with TB at the Macha Hospital in rural Zambia between September 2007 and January 2011.
Treatment outcomes among those who weighed less than 10 kg or aged younger than 3 years at treatment initiation were compared between those receiving a nevirapine (NVP) regimen and an EFV-based regimen plus treatment for TB. Researchers assigned children who weighed less than 20 kg and 30 kg with 300 mg and 400 mg of an EFV-based regimen once daily. In total, 69 patients were assigned NVP and 45 were assigned EFV.
After 1-year, overall survival was similar between the two treatment regimens: 80% for EFV-based regimen and 87% for NVP (P=.25). Compared with 78.8% of children assigned NVP, 91.7% of children assigned EFV had an undetectable viral load after 1 year (P=.19).
According to the researchers, “Children receiving EFV experienced increases in both CD4-percentage and [weight-for-age z score] during follow-up, such that levels were comparable to children receiving NVP after 2 years of ART.”
van Dijk JH. #MOPE041. Presented at: XIX International AIDS Conference; July 22-27; Washington, D.C.
The researchers report no relevant financial disclosures.