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[Viral load in HIV-infected children on high activity antiretroviral therapy]

Salvador Resino1, José M Bellón, Juan Antonio León

  • 1Laboratorio de Inmunobiología Molecular, Hospital Gregorio Marañón, Madrid, España. sresino.hgugm@salud.madrid.org

Medicina Clinica
|February 3, 2007
PubMed

Insights

High viral load (VL) before becoming undetectable predicts virological failure in children with human immunodeficiency virus (HIV). This finding aids in predicting treatment outcomes for pediatric HIV patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Immunology

Background:

  • Antiretroviral therapy (ART) aims to achieve undetectable viral load (VL) in children with human immunodeficiency virus (HIV).
  • Predicting virological failure after achieving undetectable VL is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To assess the predictive value of viral load (VL) levels before achieving undetectable VL on the subsequent re-emergence of detectable VL in vertically HIV-infected children.
  • To identify specific VL thresholds that indicate an increased risk of virological failure.

Main Methods:

  • Retrospective study involving 81 vertically HIV-infected children on ART.
  • Children were categorized into three groups based on their median VL one year before achieving undetectable VL: < 5,000 copies/ml, 5,000-30,000 copies/ml, and > 30,000 copies/ml.
  • Hazard ratios (HR) and relative risks (RR) were calculated to determine the association between pre-undetectable VL and VL rebound.

Main Results:

  • A significant proportion of children experienced VL rebound: 77.8% > 400 copies/ml, 51.8% > 5,000 copies/ml, and 33.3% > 30,000 copies/ml.
  • Children with pre-undetectable VL between 5,000-30,000 copies/ml showed a statistically significant risk of VL rebound > 5,000 copies/ml.
  • Children with pre-undetectable VL > 30,000 copies/ml had significantly higher HR for VL rebound at all tested thresholds (>500, >5,000, >30,000 copies/ml), with RR > 12 for rebound > 30,000 copies/ml.

Conclusions:

  • Elevated viral load levels prior to achieving an undetectable viral load serve as a valuable prognostic marker for virological failure in HIV-infected children.
  • These findings highlight the importance of monitoring VL trends for early identification of children at risk of treatment failure.
Abstract

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