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For young HIV-infected children previously exposed to nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitor (PI)-based therapy has been shown to be superior to NNRTI-based therapy (JW AIDS Clin Care Oct 18 2010). However, for older children without NNRTI exposure, such therapies appear equivalent (JW AIDS Clin Care Feb 14 2011). Which therapy is best for young children without perinatal NNRTI exposure?
In this study, 288 children in Africa and India who were aged 2 to 36 months (median, 1.7 years) with no prior nevirapine exposure were randomized to receive AZT, 3TC, and either nevirapine or lopinavir/ritonavir. By 24 weeks, 41% of children on nevirapine had reached the primary endpoint of virologic failure or regimen d…