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[Effectiveness of antiretroviral therapy in HIV-1 infected children. A cross-sectional study]
María I González Tomé1, J T Ramos Amador, J M Sánchez Granados
1Servicio de Inmunodeficiencias, Hospital 12 de Octubre, Madrid, Spain. maribelgt@hotmail.com
Insights
This study assessed the health status and treatments of 66 children with Human Immunodeficiency Virus type 1 (HIV-1). While most children on highly active antiretroviral therapy (HAART) achieved undetectable viral loads, new treatment complications emerged.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Immunology
Context:
- Limited cross-sectional data exist on the current clinical, immunological, and virological status of HIV-1-infected children.
- Understanding current antiretroviral therapies and their toxicities is crucial for managing pediatric HIV-1.
- This study addresses the need for descriptive data in this population.
Purpose:
- To describe the clinical, immunological, and virological status of HIV-1-infected children.
- To detail the antiretroviral therapies currently used in this cohort.
- To evaluate treatment outcomes, including viral load suppression.
Summary:
- A cross-sectional study analyzed 66 HIV-1-infected children (median age 111 months) at a tertiary hospital.
- Sixty-one children received highly active antiretroviral therapy (HAART), with 37 (56%) achieving undetectable plasma viral loads (<300 copies/ml).
- Many children had switched antiretroviral regimens multiple times, and new treatment-associated complications were observed.
Impact:
- Provides a snapshot of pediatric HIV-1 management and outcomes in a tertiary care setting.
- Highlights the effectiveness of HAART in achieving viral suppression in children.
- Underscores the ongoing challenges of managing long-term antiretroviral therapy, including emerging toxicities.
Introduction:
There are few cross-sectional studies describing the current situation of HIV-1-infected children. Such studies would be useful to determine patients' clinical and immunologic and virologic status, currently prescribed therapies and their associated toxicity.
Objectives:
To perform a descriptive analysis of the clinical, immunological and virological status of HIV-1-infected children followed-up in the pediatric unit of a tertiary hospital and describe the current antiretroviral therapies used to treat them.
Material And Methods:
A cross-sectional study was performed. Data were collected from all HIV-1-infected children followed-up until January 2002 in a large pediatric referral hospital (Hospital 12 de Octubre in Madrid). Clinical evaluation and laboratory investigations were scheduled to be performed every 3 months. The most recent CD4 and plasma viral loads were evaluated. Viral loads were considered undetectable when there were less than 300 copies/ml at the last evaluation.
Results:
Sixty-six HIV-1-infected children who were followed-up to January 2002 were analyzed. All the children acquired the infection through vertical transmission except one, in whom the mode of transmission was unknown. The median age was 111 months (18-216). Twenty children were category C. The median CD4 cell count was 953 cells/mm3 (276-3137), 28 % +/- 8 (12.42). One child was receiving no therapy, four were on combination therapy with two nucleoside reverse transcriptase inhibitors (NRTI) and 61 were receiving highly active anti-retroviral therapy (HAART). Twenty-seven children (44 %) were receiving the first HAART regimen, 23 the second, and 11 had already been switched more than twice. Overall, 37 of the 61 patients receiving HAART had an undetectable plasma viral load.
Conclusions:
Most children in our study had gone through several antiretroviral regimens, although not all children were being treated with HAART. Fifty-six percent of the patients with HAART had an undetectable plasma viral load. However, new complications associated with this therapy have begun to appear.
