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Impact of antiretroviral protocols on dynamics of AIDS progression markers
S Resino1, J M Bellón, S Sánchez-Ramón
1Department of Immunology, General University Hospital "Gregorio Marañón", Madrid, Spain.
Insights
Potent antiretroviral therapy (ART) significantly protected vertically HIV-1 infected children from progressing to AIDS. Highly active ART (HAART) demonstrated the best outcomes in this real-world observational study.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Immunology
Background:
- Antiretroviral therapy (ART) is crucial for managing vertically HIV-1 infected children.
- Understanding the real-world effectiveness of different ART regimens is essential for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the comparative effectiveness of various antiretroviral therapies (ART) in preventing AIDS progression and improving immunological and virological markers in vertically HIV-1 infected children.
- To assess the
Main Methods:
- A retrospective, multicentre observational study involving 211 vertically HIV-1 infected children.
- Children were categorized into four groups: untreated (NT), monotherapy (MT), dual-ART, and highly active ART (HAART).
- Outcomes assessed included progression to AIDS, changes in %CD4+ count, and viral load evolution.
Main Results:
- No children receiving HAART progressed to AIDS, compared to 14 in the untreated and seven in the monotherapy groups (statistically significant).
- The HAART group showed a greater mean increase in %CD4+ count (8 units/year) and a greater mean decrease in viral load (0.65 log(10) copies/ml/year) compared to other groups.
- The HAART group exhibited the lowest probability of returning to baseline %CD4+ and viral load levels.
Conclusions:
- Highly active antiretroviral therapy (HAART) provides the most significant protection against AIDS progression in vertically HIV-1 infected children.
- Real-world data supports the superior efficacy of potent ART regimens in managing pediatric HIV-1 infection.
Aims:
To assess the "real life" effectiveness of different antiretroviral therapies (ART).
Methods:
A retrospective multicentre observational study in 150 HIV-1 vertically infected children on the progression to AIDS (study A), and in 61 HIV-1 infected children on the evolution of the most relevant markers of progression (study B). All children were categorised into four groups: untreated (NT); on monotherapy (MT); on combination therapy (dual-ART); and on potent ART (HAART).
Results:
No child in the HAART group progressed to AIDS, whereas 14 children in the NT and seven in the MT groups progressed to AIDS, respectively, the differences being statistically significant. There was a mean increase of 8 units of %CD4+ per year; this was greater in the HAART group than in the other groups. The mean decrease in viral load was 0.65 log(10) copies/ml per year; this was greater in the HAART group than in the NT and MT groups. The HAART group had the lowest probability of returning to baseline %CD4+ and viral load.
Conclusion:
Potent ART had the greatest protective effect against progression to AIDS in this observational study.