Effect of antiretroviral therapy in human immunodeficiency virus-infected children.
| Title: | Effect of antiretroviral therapy in human immunodeficiency virus-infected children. |
|---|---|
| Authors: | Chearskul P; Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. pimpanada@hotmail.com; Chokephaibulkit K; Chearskul S; Phongsamart W; Plipat N; Lapphra K; Vanprapar N |
| Source: | Journal of the Medical Association of Thailand = Chotmaihet thangphaet [J Med Assoc Thai] 2005 Nov; Vol. 88 Suppl 8, pp. S221-31. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Medical Association Of Thailand Country of Publication: Thailand NLM ID: 7507216 Publication Model: Print Cited Medium: Print ISSN: 0125-2208 (Print) Linking ISSN: 01252208 NLM ISO Abbreviation: J Med Assoc Thai Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Bangkok : Medical Association Of Thailand |
| MeSH Terms: | Anti-Retroviral Agents/*therapeutic use ; HIV Infections/*drug therapy; HIV Infections/mortality ; Adolescent ; Antiretroviral Therapy, Highly Active ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Survival Analysis |
| Abstract: | Background: The appropriate timing of antiretroviral (ARV) therapy initiation in children with human immunodeficiency virus (HIV) infection has been uncertain. There was evidence of poorer outcome in adults who initiated treatment at lower baseline CD4 cell count. However, early initiation may not be possible in resource-limited setting and would increased risk of long term side effects and non-adherence.; Objective: To elucidate the outcome of HIV-infected children who ARV treatment was initiated at different disease stages.; Material and Method: Data from medical records of HIV-infected children who had been followed at Infectious Disease Division, Department of Pediatric Siriraj Hospital were retrospectively reviewed. Clinical response and outcome data were analyzed.; Results: From September 1996 to March 2004, there were 200 patients with a median age at treatment initiation of 38 (2-175) months. The median duration of follow up period was 26 (1-91) months. The median baseline CD4 cell count was 545 (2-5016) cells/mm3. The median baseline CD4 percentage was 14.25 (0.11-60). Monotherapy or dual nucleoside reverse transcriptase inhibitor (NRTI) regimens were initiated in 134 (67%), and HAARTwas initiated in 66 (33%) patients. The survival rate in patients who initiated with HAART tended to be better than those initiated with dual NRTI regimens but salvaged appropriately (p=0.2377). The survival rate in those initiated treatment at baseline CD4 > or = 15% was better than those initiated at baseline CD4 < 15% (p=0.0471).; Conclusion: Initiation of ARV treatment at CD4 more than 15% resulted in a better survival rate than at CD4 below 15%. Initiation with HAART regimen tended to improve survival and resulted in higher CD4 gain especially in cases with baseline CD4< 15%. |
| Substance Nomenclature: | 0 (Anti-Retroviral Agents) |
| Entry Date(s): | Date Created: 20060722 Date Completed: 20060822 Latest Revision: 20060721 |
| Update Code: | 20260130 |
| PMID: | 16856444 |
| Database: | MEDLINE |
Journal Article