There is now a well-functioning, safe drug available for young children with HIV that inhibits the infection. Researchers from Radboudumc have shown that an existing drug against HIV, dolutegravir, in a modified dosage of a children’s tablet is also suitable for children under twenty kilograms. The World Health Organization WHO has included the findings in the guidelines.
Optimal dosing study published in The Lancet HIV
Children with HIV
Worldwide, 1.8 million children under 15 are living with HIV, a virus that can eventually lead to AIDS if left untreated. This virus attacks its own immune system, making it easy for pathogens that are normally blocked to cause an infection. There is currently no cure, but medication can help people with HIV live a long life.
Treatment advice
For a long time there was no clear treatment advice for children. The ODYSSEY study then started, in which a large group of international scientists went in search of the best medication for children. In 2020, this was followed by advice for children over twenty kilos. Now this advice is also available for the smallest children living with HIV: who are at least 4 weeks old and who weigh between three and twenty kilos.
Researchers from Radboudumc, among others, have shown that the low-dose drug dolutegravir is easy to use and can be safely prescribed to these children. The manufacturer has developed a special children’s tablet that will also be available in low-income countries. This advice is included in the patient information of the product in Europe and America and in the treatment guidelines of the WHO.
Researchers
Researcher Angela Colbers, involved in this research together with Radboudumc colleagues Hylke Waalewijn, Pauline Bollen and David Burger: “The younger children start on HIV medication, the better, and in low-income countries we aim to equate treatment for children and adults. Dolutegravir is mainly used in adults, however there was no suitable pill available for children and the dose was unknown. Now we know that the new children’s tablet works well and what dosage we should use. Babies from four weeks who need it can safely use this medication. The drug has few side effects, it quickly inhibits virus growth and the chance of resistance is small.”
Dolutegravir is one of three drugs that children take to fight the virus.
“These drugs both target a different part of the virus, making them an effective combination”Colbers said.
Moreover, it is a relatively cheap drug that is widely available: from high to low-income countries, an important starting point for the WHO.
Healing from the virus is no closer, Colbers explains. “A lot of work is being done on other treatments and also vaccines, but unfortunately without results. The corona crisis has had consequences for the fight against HIV, but hopefully the knowledge about corona vaccines will also have a positive effect on the development of HIV vaccines. It’s not that far yet. That is why I am happy with this treatment advice for the young patients: so that we can treat them as well as possible for now.”
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