Study on Short-Term Adverse Effects of Highly Activity Antiretroviral Therapy in Children with Acquired Immunodeficiency Syndrome

Objective To study on short-term adverse effects of highly activity antiretroviral therapy(HAART) in children infected with human immunodeficiency virus(HIV)-1 or acquired immune deficiency syndrome(AIDS).Methods Seventy-one children with HIV/AIDS,including 49 male and 22 female,aged 9.2 years old (ranged 2 to 16 years) were included in this prospective observational study.Forty-five cases received zidovudine(AZT) plus lamivudine(3TC) plus nevirapine(NVP) and 26 cases received stavudine(d4T) plus 3TC plus NVP.The adverse effects including gastrointestinal diaturbances,neutropenia,hemoglobin declining,transaminase elevation,rash,serum amyalse elevation) observed within 6 months after the initiation of therapy were compared between 2 regimens.Results The major adverse effects including gastrointestinal disturbance including nausea,vomit,diarrhea,stomachache,hemoglobin decline,neutrophil decline,elevated alanine transaminase elevation(ALT),rash,serum amylase elevation were seen in 52 cases (73.2%),30 cases (42.3%),12 cases (16.9%),15 cases (21.1%),10 cases (10.4%) and 6 cases (8.5%),respectively.No differences in adverse effects incidence were observed between AZT-containing and d4T-containing regimens,except in hemoglobin decline which was much common in zidovudine(AZT)-containing regimen compared with d4T-containnig regimen (56.5% vs 16.0% P=0.001).Six cases changed regimens,3 cases changed to stavudine(d4T) due to AZT-related anemia,1 case changed to efaviren(EFV) due to NVP-related rash and 2 cases changed to EFV due to ALT e-levation.No one discontinuated HAART because of the adverse effects.Conclusions The adverse effects are mild or moderate and well tollerated in children with HIV/AIDS receiving either AZT plus 3TC plus NVP or d4T plus 3TC plus NVP.Bone marrow suppression is more common in AZT-containing regimen compared with d4T-containing regimen.