Each class-based regimen has advantages and disadvantages.
Protease inhibitor-based regimens, while highly potent, have a high pill burden and palatability challenges in children (Table 11).
NNRTI-based regimens are palatable and effective, but a low genetic barrier to resistance leads to rapid development of drug resistance mutations when therapy does not fully suppress viral replication, and there is cross-resistance among members of this drug class (Table 10).
Triple NRTI-based regimens, while sparing of other drug classes, may have lower potency than other regimens (Table 9).
Within each drug class, some drugs may be preferred over other drugs for treatment of children, based on: the extent of pediatric experience; drug formulation, including taste and volume of syrups and pill size and number; storage and food requirements; and short- and long-term toxicity.