Antiretroviral therapy outcomes of HIV-infected children in the TREAT Asia pediatric HIV observational database

• Main Authors: Rawiwan Hansudewechakul, Virat Sirisanthana, Nia Kurniati, Thanyawee Puthanakit, Pagakrong Lumbiganon, Vonthanak Saphonn, Nik Khairulddin Nik Yusoff, Nagalingeswaran Kumarasamy, Siew Moy Fong, Revathy Nallusamy, Preeyaporn Srasuebkul, Matthew Law, Annette H. Sohn, Kulkanya Chokephaibulkit
• Other Authors: Chiangrai Prachanukroh Hospital
• Format: Article
• Published: 2018
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/29441
• Institution: Mahidol University

Introduction: We report responses to combination antiretroviral therapy (cART) in the Therapeutics Research, Education, and AIDS Training in Asia Pediatric HIV Observational Database. Methods: Children included were those who had received cART (ie, ≥3 antiretrovirals) at <18 years. The analysis was intention-to-treat by the first cART regimen. Median values are provided with interquartile ranges; hazard ratios (HRs) with 95% confidence intervals. Results: Of the 1655 children included, 50.4% were male, with a median age at cART of 7.0 (3.9-9.8) years and CD4 of 8% (2.0%-15%); 92.5% were started on an NNRTI; median duration of follow-up was 2.9 (1.4-4.6) years. Loss-to-follow-up and death rates were 4.2 (3.7-4.8) and 2.1 (1.7-2.5) per 100 person-years, respectively. At 36 months, median CD4 was 26% (21%-31%); 81% of those with viral load (n = 302) were <400 copies per milliliter. Children who reached CD4 ≥25% within 5 years were more likely to be females (HR: 1.4; 1.2-1.7), start before 18 months old (HR: 3.8; 2.4-6.2), lack a history of monotherapy/dual therapy (HR: 1.7; 1.4-2.5), and have a higher baseline CD4 (per 10% increase: HR: 2; 1.9-2.2). Conclusions: These data underscore the need for early diagnosis and cART initiation to preserve immune function. © 2010 Lippincott Williams & Wilkins.