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[Analysis of antiviral therapy HIV/AIDS children from Shandong province]
Xiaoyan Zhu1, Xiaorun Tao, Guoyong Wang
1Institute of Preventive Medicine, Shandong University, Jinan 250014, China.
Insights
Antiretroviral therapy significantly improved immune function and reduced opportunistic infections in HIV-infected children in Shandong. This treatment enhances quality of life for these children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Human Immunodeficiency Virus (HIV) infection in children presents unique challenges, particularly in resource-limited settings.
- Mother-to-child transmission remains a significant route of infection, necessitating effective interventions.
- Antiretroviral therapy (ART) is the cornerstone of managing pediatric HIV.
Purpose of the Study:
- To evaluate the outcomes of HIV-infected children undergoing antiretroviral treatment in Shandong province.
- To assess the impact of ART on immunological markers, viral load, physical growth, and opportunistic infections.
Main Methods:
- A cohort of 50 HIV-infected children receiving ART in Shandong province was analyzed.
- Data were collected from the national AIDS antiviral treatment database (2009-2013).
- Follow-up included regular measurements of height, weight, CD4(+) T cell count, viral load, and opportunistic infection incidence, compared to baseline.
Main Results:
- ART led to significant increases in height, weight, and CD4(+) T cell counts compared to baseline.
- Viral load decreased significantly, with a high proportion achieving undetectable levels (≤400 copies/ml).
- The incidence of opportunistic infections dropped from 62% before treatment to 12% after ART initiation.
Conclusions:
- Antiretroviral therapy is effective in improving immune status and reducing opportunistic infections in HIV-infected children.
- ART positively impacts the quality of life for children living with HIV in Shandong province.
- Continued monitoring and treatment are crucial for managing pediatric HIV.
Objective:
To analyze the outcome among HIV-infected children following antiretroviral treatment in Shandong province.
Methods:
From the national AIDS antiviral treatment database during April 2009 and December 2013, 50 children who were according to antiviral treatment in Shandong province were classified as the cases. Regular follow-up observation and test were conducted among children under antiretroviral therapy before treatment,0.5(th), 1(th), 2(th), 3(th), 6(th), 9(th), 12(th) months after treatment, and then one time after every 3 months follow-up after one year. The height and weight of the children under antiretroviral therapy and normal children (2010 national student physical health survey results)were compared during different times. And the height and weight of the follow-up period of situation, the CD4(+)T cell count and viral load, regular physical examination results, the incidence of opportunistic infections were compared with baseline data.
Results:
Among the 50 children under antiviral therapy, male accounted for 54.0% (27/50) , female 46.0% (23/50) , the youngest was 2 years of age, the oldest was 15 years old, and all of them were transmitted by the mother-to-child route and none received mother-to-child prevention. The shortest treatment time lasted five months, the longest 61 months, with a median 25 months. The height of the baseline, 12(th), 24(th), 36(th) months after antiviral treatment were ( 111.9 ± 23.4), (118.1 ± 20.9), (127.1 ± 13.9), (135.4 ± 10.2)cm, and weigh were ( 20.6 ± 8.7), (23.8 ± 6.3), (27.8 ± 7.2), (30.7 ± 5.5) kg, respectively. The height and weight of the treated children were higher than those in the baseline (P < 0.05), but lower than those among the children without HIV infection. The CD4(+)T lymphocytes level of the baseline, 3(th), 6(th), 12(th), 24(th), 36(th) months after antiviral treatment were 224.0, 279.5, 465.0, 581.0, 640.0, 728.0/µl, the CD4(+)T lymphocytes level after antiviral treatment were higher than the baseline (P < 0.05). Hemoglobin and AST were significantly different between children received treatment after 24 months and those in the baseline (P < 0.05), baseline and 24(th) months after treatment the hemoglobin value were (106.6 ± 22.2), (125.2 ± 5.8), and the AST measurements were (42.1 ± 23.1), (23.4 ± 15.6). Baseline and 12(th), 24(th) months after treatment, the median of viral load were 10 000.0, 105.0,0.0 copies/ml , and the ratio of viral load ≤ 400 copies/ml were 50% (4/8) , 65% (22/34) , 88% (14/16) , respectively, the results of viral load had significant difference among 12(th), 24(th) months after antiviral treatment and baseline (P < 0.05). The incidence of opportunistic infections was 62% (31/50) before treatment, and 12% (6/50) after the antiviral therapy.
Conclusion:
Antiviral therapy can effectively improve the immunity and reduce the incidence of opportunistic infections which is helpful to improve the quality of life among HIV-infected children following antiretroviral treatment in Shandong province.
