Retinal Toxicity in Human Immunodeficiency Virus–infected Children Treated With 2′,3′-Dideoxyinosine

To assess the safety and antiretroviral activity of 2′,3′-dideoxyinosine, we enrolled 43 children with symptomatic (Centers for Disease Control class P-2) human immunodeficiency virus infection in a Phase I-II study and monitored them prospectively for the development of ocular complications secondary to HIV infection or drug toxicity. Follow-up ranged from 12 to 103 weeks with a median follow-up of 71 weeks. Three of 43 children (7.0%) developed peripheral atrophy of the retinal pigment epithelium during treatment with 2′,3′-dideoxyinosine. The two children with the most severe retinal atrophy were enrolled in the study at the highest dosage studied (540 mg/m 2 /day). In contrast to findings in children, no retinal atrophy in HIV-infected adults treated with 2′,3′-dideoxyinosine has been evident to date.