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In the present study nearly 30% of patients had to switch to non-stavudine based regimens, due to major side effects.
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This patient was not eligible for platinum-based regimens due to impaired renal function (prior nephrectomy) and advanced age.
The 2006 guidelines also suggested that practitioners start planning to move away from d4T-based regimens due to related toxicities [ 8].
Carboplatin may only be considered in those few patients who are unable to tolerate cisplatin-based regimens due to co-morbidities.
Despite WHO recommendations of LPV/r-based regimens for children under 3 years and EFV-based for 3 years and over, most children worldwide currently initiate on NVP-based regimens due to the low cost of NVP and its wide availability in paediatric fixed-dose combination tablets [ 4, 32].
Guided by these facts, in 2007, our group assumed and proved that moxifloxacin based treatment is effective and safe option comparing to standard triple regimens due to increased prevalence of claritromycin resistance (10.8%) [ 16] and metronidazole resistance (33%) [ 29].
We focused on misoprostol-only regimens due to the drug's low cost and accessibility.
All patients, except one, had stopped oxaliplatin- or irinotecan-containing regimens due to disease progression.
Treatment was changed from nevirapine based to efavirenz based regimen in 9 children (7 due to starting of antitubercular therapy, 2 due to NVP sensitivity), stavudine to zidovudine based regimen in 3 children (2 due to lipodystrophy, 1 due to pancreatitis), zidovudine to stavudine based therapy regimen in 8 children (6 due to anemia, 2 due to availability issues).
Consequently, these modulators have not been used in combination with any chemoradiotherapeutic or chemotherapeutic regimen, due to concerns regarding their toxicity.
Sixty three patients (17.1%) changed the regimen due to treatment failure.
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CEO of Professional Science Editing for Scientists @ prosciediting.com