Safety, efficacy, and pharmaco*kinetics of single-tablet elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide in virologically suppressed, HIV-infected children: a single-arm, open-label trial. | Semantic Scholar (2024)

E/C/FTC/TAF was well tolerated, and the antiretroviral activity and tolerability data of this combination support the use in children and adolescents, but additional studies investigating its safety and efficacy in children are paramount.

In children with human immunodeficiency virus infection failing first-line antiretroviral therapy, TAF combined with boosted PIs or dolutegravir and dosed according to WHO-recommended weight bands provides TAF and tenofovir concentrations previously demonstrated to be well tolerated and effective in adults.

INI-based regimens were effective and safe for HIV treatment in children and adolescents and presented an excellent profile, and most patients achieved and maintained viral suppression.

More than half of treatment-experienced children, adolescents and young adults with detectable viremia at INSTI initiation did not achieve viral suppression, while half of those with prior VS experienced transient viresmia.

All things considered, avoidance of TDF, particularly when aging patients are concerned, appears the preferable approach, as the permanent dysfunctional pressure exerted by TDF on the proximal renal tubule could cause irreversible damage to both kidneys and bones.

It is necessary to continue to evaluate perinatally HIV-infected children age into adolescence and adulthood with effective long-term ART, understand mechanisms underlying their risks, and identify and evaluate interventions specifically in this population.

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These data support the efficacy and safety of once daily E/C/F/TAF in HIV+ patients with mild or moderate renal impairment without dose adjustment and Proteinuria, albuminuria and bone mineral density significantly improved.

TDF substitution in children and adolescents who were otherwise stable while receiving a first-line nonnucleoside reverse transcriptase inhibitor–based regimen achieved adequate exposure without clinically significant renal or bone adverse events over 96 weeks; preliminary safety findings may not exclude delayed effects on renal function and bone density.

Compared with 300 mg TDF, TAF demonstrated more potent antiviral activity, higher peripheral blood mononuclear cell intracellular tenofovir diphosphate levels, and lower plasma TFV exposures, at approximately 1/10th of the dose.

Treatment with generic adult FDC for HIV-infected Ugandan children led to sustained clinical, immunologic and virologic response during 96 weeks of ART, indicating early initiation of ART is key to achieving virological success.

A practical discussion regarding the pharmaco*kinetics of ARV agents in pediatric HIV-infected patients, as well as the practical challenges of currently available formulations, such as palatability of liquid formulations, challenges of crushing tablets, and using adult and pediatric fixed-dose combinations.

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