Exploring the Clinical Pharmacology of Antiretroviral Agents in HIV-1 Infected Children.

Current treatment strategies have dramatically improved outcome of treatment of HIV-1 in both adults and children. Meanwhile, when compared to adults, rates of successful suppression of HIV are lower in children. This phenomenon may at least in part be explained by a relative lack of pharmacological data in children, possibly resulting in suboptimal application of antiretroviral drugs in these patients. In addition, the absence of pharmacological data for several antiretroviral drug regimens in children reduces the options for combination treatment in HIV-1 infected children. The studies in this thesis explored the clinical pharmacology of antiretroviral agents in HIV-1 infected children. Their main objective was to optimize existing or not yet applied treatment combinations in HIV-1 infected children. For this purpose, pharmacokinetic-pharmacodynamic relationships and drug-drug interactions with antiretroviral agents were investigated. Also, pediatric doses of antiretroviral agents were defined or optimized. Finally, the role of therapeutic drug monitoring in HIV-1 infected children was evaluated.