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Decrease in hospitalization and mortality rates among children with perinatally acquired HIV type 1 infection
Rolando M Viani1, Maria R G Araneta, Jaime G Deville
1Department of Pediatrics, School of Medicine, University of California-San Diego, La Jolla, CA 92093-0672, USA. rviani@ucsd.edu
Summary
Highly active antiretroviral therapy (HAART) significantly improved health outcomes for children with HIV-1. Treatment advances led to lower hospitalization and mortality rates, alongside better immune function and viral load control.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- Limited data exists on highly active antiretroviral therapy (HAART) impact on perinatally infected children with human immunodeficiency virus type 1 (HIV-1).
- Understanding evolving antiretroviral therapy effects on pediatric HIV-1 disease progression is crucial.
Purpose of the Study:
- To evaluate the effect of changing antiretroviral therapy on immunologic and virologic status in perinatally HIV-1 infected children.
- To assess the impact of HAART on hospitalization and mortality rates in this population.
Main Methods:
- Longitudinal observation of 129 children at 3 HIV clinics from 1994-2001.
- Monitoring CD4+ cell percentage, plasma HIV-1 RNA load, antiretroviral treatment, and hospitalization rates.
- Analysis of Pneumocystis jiroveci pneumonia (PCP) prophylaxis use.
Main Results:
- CD4+ cell percentage increased (22.5% to 31.2%), while HIV-1 RNA load decreased (4.53 to 3.27 log10 copies/mL) from 1994-2001.
- HAART use rose from 0% to 93%, with a decrease in PCP prophylaxis.
- Hospitalization rates significantly declined (6.49 to 0.60 per 100 person-years), including AIDS-related admissions.
Conclusions:
- Significant reductions in HIV-1-associated mortality and hospitalization were observed in perinatally infected children between 1994 and 2001.
- These improvements correlated with increased HAART use, higher CD4+ counts, and lower HIV-1 RNA viral loads.
- HAART demonstrated a significant survival benefit in this pediatric cohort.