The safety and activity of several
antiretroviral agents are being evaluated for treatment of
acquired immunodeficiency syndrome (
AIDS) in infants and children. Intermittent oral and intravenous regimens and continuous
intravenous infusion of the dideoxynucleoside,
3'-azido-3'-deoxythymidine (
zidovudine, AZT), have been shown to be beneficial in improving neuro-developmental function and growth velocity in pediatric patients with
AIDS. AZT, however, is limited by the associated development of
neutropenia and
anemia, which frequently necessitates transfusions. Another dideoxynucleoside,
2',3'-dideoxycytidine (ddC), also shows theoretical promise in the treatment of the pediatric
AIDS population. This agent is not associated with the hematologic toxicity induced by AZT but does produce a painful sensory
peripheral neuropathy. Sequential
therapy with AZT and ddC may limit the toxic effects associated with the use of these drugs individually.
Dideoxyinosine and soluble recombinant CD4 are two newer
antiretroviral agents that are under investigation for the management of
AIDS in infants and children. The activity of recombinant CD4 in preventing the transplacental transmission of human immunodeficiency virus is also being evaluated.