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The World Health Organization (WHO) is updating its guidelines for the treatment of children with HIV. This change is based on an international study conducted by among others Radboudumc. As a result, children with HIV around the world will now receive the treatment best suited to their needs.
HIV patients are always treated with a combination of three types of medication. Previous research primarily focused on adults, leaving uncertainty about which combination of drugs works best for children. A large study led by UCL (University College London) Great Ormond Street Institute of Child Health is now changing that. In this study, Radboudumc, under the leadership of hospital pharmacist David Burger, examined the ideal dosage and formulation for each drug, specifically tailored for children in developing countries.
The study included 919 children from Uganda, Zambia, and Zimbabwe. David Burger explains: “First, we determined the appropriate dosage and formulation for each drug. After that we tested all possible combinations. We also took into account other factors such as diet, malnutrition, or underlying illnesses. And of course, we looked at efficacy and side effects.”
The best suited treatment
The outcome of the study provides clarity on the best treatment options for children for whom the initial treatment is no longer effective or causes too many side effects. “Some patients don’t respond well, or well enough, to the first line of treatment. We can now help those children much more effectively, so that HIV no longer needs to be a fatal disease for them,” says Burger.
The study was funded by a European grant and published in The New England Journal of Medicine. Medication in developing countries is largely funded by the United States. However, recent political developments may put that funding at risk. “We have worked intensively for years to reach this recommendation. I hope we can continue to provide children in developing countries with the daily medication they need,” Burger concludes.
On this photo: professor Clinical Pharmacy David Burger
About the publication
This study has been published in The New England Journal of Medicine: Second-Line Antiretroviral Therapy for Children Living with HIV in Africa. V. Musiime, M. Bwakura-Dangarembizi, A.J. Szubert, V. Mumbiro, H.A. Mujuru, C.M. Kityo, A. Lugemwa, K. Doerholt, C. Chabala, S. Makumbi, V. Mulenga, H. McIlleron, D. Burger […] A.S. Walker, A. Bamford, and D.M. Gibb, for the CHAPAS-4 Trial Team. DOI: 10.1056/NEJMoa2404597
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