Palatability of antiretroviral drugs in children with HIV a 16-year retrospective study in a large urban centre

Abstract

Poor adherence to antiretroviral therapy (ART) contributes to viral resistance and thus treatment failure in children with HIV. Adherence to antiretroviral medications among children is frequently suboptimal. Palatability is an important factor in adherence but there have been very few data in this patient population. The clinical records of all the children referred to a major urban HIV clinic between 1987 to 2003 were reviewed with attention to palatability problems in ART. There were 119 children (aged 0–18) who were HIV infected and treated with ART (66 male, 53 female). Most children were on more than one ART during their treatment (86%) and 14 different ART were used among these patients. Ritonavir (n=44) was the least palatable drug with 45.5% of treated children disliking its taste. In half of these ritonavir patients who disliked its taste, the problem with palatability led to treatment discontinuation. The taste of nelfinavir (n=51) was disliked in 11.8% of the 51 children it treated, didanosine in 14.3% of 42 children and amprenavir in 50% of 4 children. Didanosine (n=14), nevirapine (n=23), efavirenz (n=17), saquinavir (n=5), indinavir (n=8) and lopinavir (n=20) received no complaints regarding palatability. Since there are differences in ART palatability, a prospective study of the palatability of different ART in children is needed. Such data would allow pediatric clinicians to consider an important additional factor besides efficacy in ART selection. Clinical Pharmacology & Therapeutics (2004) 75, P14–P14; doi: 10.1016/j.clpt.2003.11.052