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Updated: May 11, 2025

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

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IMMUNOLOGICAL AND VIROLOGIC OUTCOMES WITHIN TEN YEARS OF COMBINED ANTIRETROVIRAL THERAPY INITIATED BEFORE ONE YEAR OF

Francis Ateba Ndongo1, Mathurin Cyrille Tejiokem2, Calixte Ida Penda3

  • 1MD,PhD, University of Garoua; Centre Mère et Enfant de la Fondation Chantal Biya; Ministry of Public Health; Yaounde, Cameroon;

Journal of Acquired Immune Deficiency Syndromes (1999)
|April 17, 2025
PubMed

Insights

Early combined Antiretroviral Therapy (cART) in children with perinatal HIV shows long-term benefits but is hampered by initial high mortality. Early infant HIV screening is crucial to improve outcomes and prevent advanced disease.

Area of Science:

  • Pediatric Infectious Diseases
  • HIV/AIDS Research
  • Public Health in Sub-Saharan Africa

Background:

  • Perinatal HIV infection presents significant long-term health challenges for children.
  • Early initiation of combined Antiretroviral Therapy (cART) is critical for managing pediatric HIV.
  • Understanding long-term outcomes of early cART in resource-limited settings is essential.

Purpose of the Study:

  • To evaluate immunological and virologic outcomes within 10 years of early cART initiation in Cameroonian children with perinatal HIV.
  • To identify factors associated with long-term treatment success in this population.
  • To inform public health strategies for pediatric HIV management.

Main Methods:

  • Prospective cohort study conducted in 3 referral hospitals in Cameroon.
  • Time-to-event analysis used to assess probabilities of viral suppression, sustained viral suppression, immunocompetence, and mortality.
  • Data collected on demographics, treatment regimens, and home conditions.

Main Results:

  • At 10 years, an estimated 22.0% mortality occurred, primarily in the first two years due to advanced HIV disease.
  • Viral suppression (VS) was achieved by 72.0% of children, with 70.0% maintaining it.
  • Immunocompetence increased significantly from 45.3% at baseline to 88.6% at 10 years.
  • Receiving ritonavir-boosted lopinavir (LPV/r)-based regimens and baseline immunocompetence were associated with sustained VS.

Conclusions:

  • High early mortality significantly impairs the long-term efficacy of early cART in children with perinatal HIV.
  • Community-based screening strategies are vital for early HIV detection in infants before advanced disease develops.
  • Optimizing treatment regimens and early intervention are key to improving long-term survival and health in vertically infected children.
Abstract

Keywords:
childrenearly ART initiationperinatal HIVvirological suppression

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