1. Roles of Protease Inhibitors for HIV-infected Children Jintanat Ananworanich

2. National Security Office Database As of July 20, 2013 – N of Thai children on ART = 5543 – N of children on LPV/r = 1548 – N of children on ATV/r = 32 – Also some children on double-boosted PI (LPV/r + SQV or IDV) and on IDV/r – A few on unboosted IDV or treatment dose of RTV (not recommended) Data from Mr. Artit Pusamang and Dr. Sorakij Bhakeecheep

3. Use of PI in Treating Pediatric HIV First-line Second-line Third-line/salvage Failure ~ 30% at 4 yrs 1 Failure ~ 30% at 1 yr 2 Failure ~ 20% at 7 mo 3 1 Puthanakit T, PIDJ 2007; 2 Puthanakit T, AIDS Res Ther 2012; 3 Ananworanich J, 2012 IAS N=1600 in NHSO N=480 N=96

4. HIVNAT 113 patient population (Failed NRTI/NNRTI/PI) ParametersValues Total N47 Mean age16.5 years N for each DRV/r dosing 20 to < 30kg (375/100mg) 30 to < 40kg (450/100mg) ≥ 40kg (600/100mg) 20% 35% 45% HIV-NAT, Siriraj, Bamrasnaradura, Srinagarind, Nakornping, Chiang Rai, Prapokklao, Surin

5. Data in Adults

6. Virologic Responses of Commonly Used Third ARV for the Initial HAART Data from various clinical trials of treatment-naïve patients % of patients with VL<50 at 96 weeks except STARTMRK at 48 weeks (ITT) *EFV, ATV/r, DRV/r superiority to LPV/r All combined with 2 NRTIs ACTG5142 STARTMRK CASTLE ARTEMIS ACTG 5142, CASTLE, ARTEMIS = 96 weeks, STARTMRK=48 weeks results From the slide collection of Prof. Kiat Ruxrungtham

7. Virologic Responses in Treatment- experienced Trials (most data at 48 wks) Wk 96 Wk 144 Active 50% 37%<33% 75% 17% OBR≥2 ETR+DRV/r RAL DRV/r MVC DRV/r DRV/r RAL+ETR+DRV/r ENF