Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy

被引：32

作者：

Chiappini, Elena ^{[1
]}

Galli, Luisa ^{[1
]}

Tovo, Pier-Angelo ^{[2
]}

Gabiano, Clara ^{[2
]}

Lisi, Catiuscia ^{[3
]}

Bernardi, Stefania ^{[4
]}

Vigano, Alessandra ^{[5
]}

Guarino, Alfredo ^{[6
]}

Giaquinto, Carlo ^{[7
]}

Esposito, Susanna ^{[8
]}

Badolato, Raffaele ^{[9
]}

Di Bari, Cesare ^{[10
]}

Rosso, Raffaella ^{[11
]}

Genovese, Orazio ^{[12
]}

Masi, Massimo ^{[13
]}

Mazza, Antonio ^{[14
]}

de Martino, Maurizio ^{[1
]}

机构：

[1] Univ Florence, Dept Pediat, Florence, Italy

[2] Univ Turin, Dept Pediat, I-10124 Turin, Italy

[3] Univ Florence, Dept Stat, Florence, Italy

[4] Bambino Gesu Pediat Hosp, Pediat Clin, Rome, Italy

[5] Univ Milan, Infect Dis Unit, Dept Paediat, L Sacco Hosp, Milan, Italy

[6] Univ Naples Federico II, Dept Pediat, Naples, Italy

[7] Univ Padua, Dept Pediat, Padua, Italy

[8] Univ Milan, Dept Maternal & Pediat Sci, Fdn IRCCS, Osped Maggiore Policlin Mangiagali & Regina Elena, Milan, Italy

[9] Univ Brescia, Pediat Clin, Brescia, Italy

[10] Giovanni XXIII Pediat Hosp, Clin Infect Dis, Bari, Italy

[11] Univ Genoa, Osped San Martino Genova, Infect Dis Clin, Genoa, Italy

[12] Gemelli Hosp, Pediat Intens Unit, Rome, Italy

[13] Univ Bologna, Pediat Clin, S Orsola Hosp, Bologna, Italy

[14] Santa Chiara Hosp, Paediat Unit, Trento, Italy

来源：

BMC INFECTIOUS DISEASES | 2009年 / 9卷

关键词：

PROTEASE INHIBITOR SUBSTITUTION; MORTALITY; INFANTS;

D O I：

10.1186/1471-2334-9-140

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Early highly active antiretroviral therapy ( HAART), started within the first months of age, has been proven to be the optimal strategy to prevent immunological and clinical deterioration in perinatally HIV-infected children. Nevertheless, data about long-term follow-up of early treated children are lacking. Methods: We report data from 40 perinatally HIV-infected-children receiving early HAART, with a median follow-up period of 5.96 years (interquartile range [IQR]: 4.21-7.62). Children were enrolled at birth in the Italian Register for HIV Infection in Children. Comparison with 91 infected children born in the same period, followed-up from birth, and receiving deferred treatment was also provided. Results: Nineteen children (47.5%) were still receiving their first HAART regimen at last follow-up. In the remaining children the first regimen was discontinued, after a median period of 3.77 years (IQR: 1.71-5.71) because of viral failure (8 cases), liver toxicity (1 case), structured therapy interruption (3 cases), or simplification/switch to a PI-sparing regimen (9 cases). Thirty-nine (97.5%) children showed CD4(+) T-lymphocyte values>25%, and undetectable viral load was reached in 31 (77.5%) children at last visit. Early treated children displayed significantly lower viral load than not-early treated children, until 6 years of age, and higher median CD4(+) T-lymphocyte percentages until 4 years of age. Twenty-seven (29.7%) not-early treated vs. 0/40 early treated children were in clinical category C at last follow-up (P < 0.0001). Conclusion: Our findings suggest that clinical, virologic and immunological advantages from early-HAART are long-lasting. Recommendations indicating the long-term management of early treated children are needed.

引用

页数：6

共 13 条

[11] Effectiveness of early initiation of protease inhibitor-sparing antiretroviral regimen in human immunodeficiency virus-1 vertically infected infants [J].