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Clinical outcomes improve with highly active antiretroviral therapy in vertically HIV type-1-infected children

Salvador Resino1, Rosa Resino, José Maria Bellón

  • 1Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, Madrid, Spain. sresino.hgugm@salud.madrid.org

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|June 17, 2006
PubMed

Insights

Highly active antiretroviral therapy (HAART) significantly reduced AIDS cases, deaths, and hospitalizations in vertically HIV-1 infected children. This effective treatment protocol improved CD4 counts and viral load, enhancing overall clinical outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Public Health

Background:

  • Antiretroviral therapy (ART) has improved outcomes for children with human immunodeficiency virus type 1 (HIV-1).
  • Effectiveness of different ART protocols on clinical outcomes in children requires ongoing evaluation.
  • Vertical HIV-1 transmission poses significant health challenges in pediatric populations.

Purpose of the Study:

  • To evaluate the effectiveness of various antiretroviral therapy protocols on clinical outcomes in vertically HIV-1 infected children.
  • To assess changes in CD4(+) cell counts, viral load, and adverse clinical events over distinct treatment eras.

Main Methods:

  • Retrospective study of 427 vertically HIV-1 infected children.
  • Follow-up divided into five calendar periods (CPs) reflecting evolving ART strategies (pre-ART, monotherapy, combination therapy, partial HAART, full HAART).
  • Analysis of clinical outcomes including AIDS incidence, mortality, hospital admissions, and hospitalization duration.

Main Results:

  • Significant improvements in CD4(+) cell count and viral load observed from 1997 onwards with HAART.
  • CP5 (1999-2003), with >60% HAART use, showed significantly lower AIDS cases (2%) and deaths (0.5%) compared to earlier periods.
  • HAART era (CP4 & CP5) demonstrated >3.5 relative risk for no hospital admission and reduced hospitalization duration.

Conclusions:

  • Highly active antiretroviral therapy (HAART) is highly effective in reducing adverse clinical outcomes in vertically HIV-1 infected children.
  • Transition to HAART protocols led to substantial decreases in AIDS incidence, mortality, and hospitalizations.
  • Findings support the critical role of HAART in managing pediatric HIV-1 infection, as demonstrated in Madrid, Spain.

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