Efficacy and safety of stavudine plus didanosine in asymptomatic HIV-infected children with plasma HIV RNA below 50,000 copies per milliliter.

Background: Simple antiretroviral drug combinations might provide a comparable benefit to standard triple regimens in patients with mild HIV disease, because poor adherence and toxicities often compromise the sustained benefit of the latest triple regimens, especially when protease inhibitors are used. Bad adherence is the main cause of virological failure in HIV-positive children. The activity and safety of a double combination of nucleosides with high genetic barrier for resistance (stavudine plus didanosine) was assessed in children with nonadvanced HIV disease.

Liver toxicity caused by nevirapine.

Nevirapine plasma levels were measured in 70 HIV-infected patients, 33 of whom developed transaminase elevations. Higher nevirapine levels and hepatitis C virus infection were found to be independent predictors of liver toxicity. Moreover, in individuals with chronic hepatitis C, nevirapine concentrations greater than 6 microg/ml were associated with a 92% risk of liver toxicity.

Different degree of immune recovery using antiretroviral regimens with protease inhibitors or non-nucleosides.

Background: Protease inhibitors (PI) produce significant immune recovery in most HIV-infected persons, although toxicity and high pill burden often limit this benefit. Combinations including non-nucleoside reverse transcriptase inhibitors (NNRTI) result in similar virological success, but data on immune reconstitution are scarce.

Methods: Baseline plasma viraemia and CD4 cell counts were recorded from 100 patients who began two nucleoside analogue reverse transcriptase inhibitors plus either one PI or one NNRTI in a case-control study [indinavir (82%) and nevirapine (80%), respectively, were most frequently prescribed].