Extensive implementation of highly active antiretroviral therapy shows great effect on survival and surrogate markers in vertically HIV-infected children.
We performed a retrospective observational study of 253 children vertically infected with human immunodeficiency virus (1994-2001) to assess the effectiveness of antiretroviral therapies (ARTs) on survival and surrogate markers at the population level. Children were divided into 3 groups according to the ART protocols used during the follow-up period: calendar period (CP) 1 (1994-1996) received combined therapy with 2 nucleoside reverse transcriptase inhibitors (NRTIs); CP2 (1997-1998) received implementation of highly active ART (HAART) with 3 drugs (NRTIs, protease inhibitors, and non-NRTIs); and CP3 (1999-2001) received extensive HAART. The children in the CP3 group had statistically significant longer survival periods, lower virus load (VL), highest undetectable VL proportion, and highest CD4+ T cell counts. HAART is effective at the population level at decreasing VL, increasing CD4+ T cells, and increasing the survival in a higher percentage of HIV-infected children.
Resino
Salvador
S
Laboratorio de Inmunobiologia of Hospital Gregorio Maranon, Madrid, Spain.
Bellon
José Ma
JM
Resino
Rosa
R
Navarro
Ma Luisa
ML
Tomás Ramos
José
J
de José
Ma Isabel
MI
Mellado
Ma José
MJ
Muñoz-Fernández
Ma Angeles
MA
D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D015415:Biomarkers / Q000032:analysis; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality / Q000635:transmission*; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors / Q000502:physiology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D016019:Survival Analysis; D013995:Time; D019562:Viral Load / Q000639:trends
D019380:Anti-HIV Agents; D015415:Biomarkers; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase