Trial to evaluate steady state pharmacokinetic parameters of nevirapine 150mg/m2 and nevirapine 4 or 7 mg/kg after 4 weeks, and efficacy and safety of the dosing when administered for 48 weeks in antiretroviral drug naïve paediatric patients.

A randomised open label multi-centre trial to evaluate the pharmacokinetic, efficacy and safety parameters of nevirapine 150mg/m2 and nevirapine 4 or 7mg/kg when administered in combination with ZDV and 3TC for 48 weeks in antiretroviral naive pediatric patients.

Primary objective: To evaluate steady state pharmacokinetic parameters of nevirapine 150mg/m2 in antiretroviral drug naive pediatric patients.

Secondary objective: To assess efficacy and safety of nevirapine 150 mg/m2 and nevirapine 4/7mg/kg after 24 and 48 weeks of treatment

Study Hypothesis:

Evaluation of recent pharmacokinetic data has suggested that a dose based on body surface area rather than body weight might be a better therapeutic regimen to achieve steady state plasma concentrations. The goal in this study was to determine if a Nevirapine suspension dose of 150 mg/m2 BID, following a two week lead-in of 150 mg/m2 QD, produces plasma nevirapine steady state concentrations of 4 - 6 ?g/mL in all age groups as was observed in adult safety and efficacy trials.

Comparison(s):

ACTG 245

Inclusion:

1. Male or female patients between 3 months and 16 years of age at day 28 of the study.
2. Evidence of HIV-1 infection
3. Patients who are antiretroviral drug naive
4. Plasma viral load detectable
5. CD4 >=50 cells/cc3
6. Written informed permission
7. Active assent given by the patient if the child is capable of understanding the given information
8. Reasonable probability for completion of the trial

Exclusion:

1. Any significant disease, other than HIV
2. Any acute illness within 2 weeks prior to Day 0
3. Patients requiring the continued use of inhibitors or inducers of P450 metabolic enzymes
4. Patients requiring systematic treatment with CYP3A4 substrates
5. Patients with malabsorption, severe chronic diarrhea
6. Receipt of any cytotoxic therapy for malignancy
7. Current grade 3 or 4 clinical or laboratory toxicity
8. Pregnancy or breast-feeding
9. Females of childbearing potential not using adequate contraception. allergy or known drug hypersensitivity to any of the study drugs intravenous drug abuse, alcohol or substance abuse