Switching Nevirapine-Exposed, Virologically Suppressed Children to an Efavirenz-Based Antiretroviral Regimen

Lopinavir/ritonavir therapy is the currently recommended first-line treatment for HIV-infected children. Lopinavir/r syrup, which is administered twice daily, tastes unpleasant, requires cold storage, and can result in metabolic toxicities with long-term use. In a randomized, open-label, noninferiority trial conducted in South Africa, researchers assessed whether HIV-infected children who had previously been exposed to nevirapine for prevention of mother-to-child transmission and had achieved suppression on lopinavir/r-based therapy could be transitioned to an efavirenz-based regimen without increased risk for virologic failure.

By 48 weeks, 3% (4/150) of efavirenz-group children and 2% (3/148) of lopinavir/r-group children had experienced v…