Optimizing Pediatric Dosing Recommendations and Treatment Management of Antiretroviral Drugs Using Therapeutic Drug Monitoring Data in Children Living With HIV

Abstract

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Are There Effects of Antiretroviral Usage, Caregiver Stigma, Caregiver Burden, and Caregiver Coping on the Quality of Life of Indonesian Children with HIV/AIDS?

“…This study found that ARV drugs improves the quality of life of Indonesian children with HIV/AIDS, which is a condition consistent with some previous studies [17][18][19]. ARV therapy suppresses viral replication and reduces viral load in blood thereby boosting immune system [20], and has been shown to improve physical functioning of children with HIV/AIDS [21].…”

“…The caregiver stigma measurement obtained a value of 21.7 ± 2.06, with a median value of 22 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). There was no signi cant effect between caregiver stigma on the quality of life of Indonesian children with HIV/AIDS (β = 0.064; p = 0.548), with value of each subscale as follows: physical function (β = 0.023; p = 0.845), emotional function (β = -0.066; p = 0.608), social function (β = 0.007; p = 0.957), and school function (β = 0.097; p = 0.418).…”

“…quality of life (71.7%; β = 0.683; p < 0.001). Caregiver stigma value was 21.7 ± 2.06, with a median value of 22 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26); β = 0.064; p = 0.548). Participants had moderate and mild caregiver burden, with percentage of 50.9% and 49.1%, respectively (β = 0.058; p = 0.593).…”

The Pharmacogenetics of Efavirenz Metabolism in Children: The Potential Genetic and Medical Contributions to Child Development in the Context of Long‐Term ARV Treatment

“…Finally, in a review of all of the literature to date on ARV dosing for individuals with a median or mean age ≤ 18 under the current international guidelines for ARV dosage (Waalewijn et al, 2019), it is noted that pediatric ARV dosing is often based on small samples, and simplified to provide practical information across general contexts of disease. Yet there is high interindividual variation in the pharmacokinetic parameters of pediatric ARVs, indicating a potential risk of under-or overdosing, and therefore more close monitoring of ARV dosing, and related factors, is needed.…”

Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection: a systematic review

“…Dose recommendations for paediatric ART are often based on small studies, but paediatric ART dose optimization is becoming increasingly important in drug development. 15 There are, however, still many knowledge gaps concerning ART in children receiving concomitant TB treatment, and vice versa. 16 First-line treatment of drug-susceptible TB in children consists of isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months, followed by isoniazid and rifampicin for 4 months.…”