Palumbo 2010.
Methods | Phase II randomised clinical trial | |
Participants | 123 children less than 36 months old Age:> 6 months to < 36 months (up to but not including the 3rd birthday) Inclusion criteria: If either the mother or the child had received NVP; subsequently amended to require specifically that the child had received nevirapine. Had to have diagnosis or AIDS by 60 days from birth and be formula fed from birth. Treatment eligible as defined by the WHO paediatric algorithm. HIV‐1 RNA >5,000 copies/mL within 60 days prior to study entry/randomisation Exclusion criteria: TB treatment or not met inclusion criteria |
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Interventions | NVP‐based vs LPV/r‐based first line antiretroviral therapy | |
Outcomes | Treatment failure (virological failure or discontinuation for any cause included death); virological failure; change in CD4%; change in weight and height z scores; adverse events. | |
Notes | Enrollment was terminated early on the recommendation of the data and safety monitoring board. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote from the protocol: "dynamic permuted block system [stratified (<12months>)] " |
Allocation concealment (selection bias) | Low risk | Quote from correspondence: "The Subject Registration and Randomization System provides a web‐based interface that leads site personnel through the checklist. If the subject satisfies the entry criteria, the system stores the subject's information in the central database and assigns a treatment based on a permuted block algorithm" |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | None (from correspondence), but outcomes are unlikely to be biased by unmasking |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | None (from correspondence), but outcome measurements are unlikely to be biased by unmasking |
Incomplete outcome data (attrition bias) All outcomes | Low risk | ITT was performed and attrition bias is unlikely |
Selective reporting (reporting bias) | Low risk | Protocol available, selective outcome reporting is unlikely |
Other bias | Unclear risk | Early termination of the study: "Enrollment in this cohort was terminated early on the recommendation of the data and safety monitoring board." |