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Immunological and Virological Responses to Highly Active Antiretroviral Therapy in HIV-1 Infected Children
Ravinder Singh1, Aparna Mukherjee1, Mohit Singla1
1Department of Pediatrics, All India Institute of Medical Sciences, Room no. 3061A, New Delhi, 110029, India.
Insights
Highly active antiretroviral therapy (HAART) improved immune function in HIV-infected children. However, viral load suppression was less effective, with only 20.2% achieving optimal immuno-virological response after six months.
Area of Science:
- Pediatrics
- Immunology
- Virology
Background:
- Human immunodeficiency virus (HIV) infection remains a significant health concern in children.
- Highly active antiretroviral therapy (HAART) is the standard of care for pediatric HIV.
- Evaluating treatment outcomes is crucial for optimizing pediatric HIV management.
Purpose of the Study:
- To assess the immunological and virological effects of HAART in HIV-infected children.
- To determine the proportion of children achieving optimal treatment response at six months.
- To identify challenges in achieving robust virological suppression.
Main Methods:
- Retrospective review of medical records of HIV-infected children under 15 years old.
- Inclusion criteria: initiation of HAART between 2010-2014 with available CD4+ T cell percentage and HIV-1 viral load at baseline and 6 months.
- Data analysis focused on changes in CD4+ T cell percentage and viral load.
Main Results:
- Seventy-four children were included; median age was 36 months.
- After 6 months of HAART, a median increase of 11% in CD4+ T cell percentage was observed.
- Only 20.2% of children achieved both increased CD4+ T cell percentage (≥15%) and undetectable viral load (<47 copies/ml).
Conclusions:
- HAART demonstrated effectiveness in improving immunological parameters in HIV-infected children.
- Virological responses to HAART were suboptimal in a significant proportion of the studied cohort.
- Further research may be needed to enhance viral suppression strategies in pediatric HIV treatment.
Objective:
To evaluate immunological and virological outcomes in human immunodeficiency virus (HIV) infected children at six months of highly active antiretroviral therapy (HAART).
Methods:
Records of HIV infected children <15-y-old were reviewed to identify those who were initiated highly active antiretroviral therapy between 2010 and 2014 and had CD4+ T cell percentage and HIV-1 viral load report at baseline visit and after 6 mo of initiation of the treatment.
Results:
Seventy-four HIV infected children [26% girls, median age IQR 36 (24-108) mo] were included in the study. At the end of six months of HAART, median increase of 11% (6-15%) in CD4+ T cell percentage from the baseline levels was observed; nineteen (26%) children showed an increase in CD4+ T cell percentage of 15% or more at 6 mo. Viral load was undetectable (<47 copies/ml) in 27 (36.4%) children; 21 (28.3%) children had 47- < 500 copies/ml; 16 (21.6%) children had 500- < 10,000 copies/ml and 10 (13.5%) children had ≥10,000 copies/ml. At six months, only 15 (20.2%) children exhibited positive immuno-virological response to HAART (≥ 15% increase in CD4% and <47 HIV-1 RNA copies/ml).
Conclusions:
While HAART was effective in improving the immunological and virological parameters in the index cohort of children, virological responses were less robust.
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