Hospitalization and mortality among HIV-infected children after receiving highly active antiretroviral therapy

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Thanyawee Puthanakit1, Linda Aurpibul, Peninnah Oberdorfer

  • 1Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand 50202. tputhana@mail.med.cmu.ac.th

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 24, 2007
PubMed

Insights

Highly active antiretroviral therapy (HAART) significantly reduced hospitalization and mortality in HIV-infected children. Most events occurred within the first 24 weeks of treatment, highlighting an early critical period for pediatric HIV care.

Area of Science:

  • Pediatric Infectious Diseases
  • Public Health in Resource-Limited Settings
  • Antiretroviral Therapy Research

Background:

  • Pediatric antiretroviral therapy (ART) programs are expanding in resource-limited settings.
  • The impact of highly active antiretroviral therapy (HAART) on pediatric HIV cohorts in these areas requires further documentation.
  • This study evaluated hospitalization and mortality rates in HIV-infected Thai children on HAART.

Purpose of the Study:

  • To assess the rates and causes of hospitalization among HIV-infected Thai children receiving HAART.
  • To determine the mortality rates in this pediatric cohort.
  • To analyze the impact of HAART over time on clinical outcomes.

Main Methods:

  • Prospective observation of antiretroviral-naive HIV-infected children (CD4% ≤15%) starting HAART between August 2002 and March 2005.
  • Study included 192 children, with a minimum follow-up of 48 weeks.
  • Data collected on age, CD4 cell percentage, plasma HIV RNA levels, hospitalizations, and mortality.

Main Results:

  • Hospitalization rates decreased significantly from 30.7% in the first 24 weeks to 2.0% by weeks 120-144.
  • Pneumonia and bacterial infections were the primary causes of hospitalization (61.7%), followed by immune reconstitution syndrome (23.4%).
  • Mortality rates declined from 5.7% in the first 24 weeks to 0%-0.6% in subsequent periods.

Conclusions:

  • HAART significantly reduced hospitalization and mortality in HIV-infected children.
  • The initial 24 weeks of HAART represent a critical period for managing hospitalizations and mortality.
  • Findings underscore the importance of close monitoring during early HAART initiation in pediatric HIV management.
Abstract

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