Research in context
Evidence before this study
The treatment of people younger than 18 years with HIV-1 infection is evolving. Few data exist on the short-term use of integrase inhibitors in all children and no data exist regarding their long-term use. We searched PubMed for studies published from Jan 1, 2010, to Dec 30, 2017, with the search terms “integrase inhibitors”, “children”, “youth”, “adolescents and infants”, and “long term”, but restricted studies to those published in the English language. We found no indication that such data had been published to date.
Added value of this study
This long-term follow-up study of 122 young patients (aged 4 weeks to 18 years) with HIV-1 infection receiving three different, age-appropriate, formulations of raltegravir showed that this integrase inhibitor was well tolerated and had favourable virological outcomes. Older children, who were often highly treatment experienced, had lower proportions of virological success than did children younger than 12 years.
Implications of all the available evidence
Our study suggests that raltegravir can be used for the treatment of HIV-1 infection in children as young as 4 weeks, with the expectation of long-term safety and efficacy, but should be used with caution among older children who have had previous extensive antiretroviral therapy.