Highly active antiretroviral therapies among HIV-1-infected children in Abidjan, Côte d'Ivoire.
OBJECTIVE
To describe the effect of highly active antiretroviral therapy (HAART) in HIV-1-infected African children.


METHODS
Observational ANRS 1244 cohort of 159 children with HIV between October 2000 and September 2002; 78 children (49%) receiving HAART were followed for a mean duration of 21 months.


METHODS
Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ), CD4 lymphocyte count and HIV-1 RNA viral load were measured before initiating HAART and every 6 months during treatment. Probability of survival and incidences of pneumonia and acute diarrhoea were calculated.


RESULTS
Values before and after 620 days of HAART, respectively, were -2.02 and -1.39 for mean WAZ, (P < 0.01); -2.03 and -1.83 for mean HAZ (P = 0.51); 0.07 and 0.025/child-month (P = 0.002) for incidence of pneumonia; and 0.12 and 0.048/child-month for incidence of acute diarrhoea (P < 0.001) (incidence changes statistically significant only in children < 6.5 years). Overall, the probability of survival under HAART was 72.8% at 24 months for children with < 5% CD4 cells versus 97.8% in children with >/= 5% (P < 0.01). At HAART initiation, median viral load and CD4 cell percentage were 5.41 log10 copies/ml and 7.7%, respectively. After 756 days of HAART, on average, 50% of patients had undetectable viral load and 10% had 2.4-3.0 log10 copies/ml. The median CD4 percentage was 22.5%.


CONCLUSIONS
In resource-limited setting, it is possible to use HAART to treat African children. This treatment appears as effective as in developed countries.
Fassinou
Patricia
P
Pediatric Service, Centre Hospitalier of Yopougon, the Children's Programme Yopougon, France.
Elenga
Narcisse
N
Rouet
François
F
Laguide
Rockiath
R
Kouakoussui
Kouakou A
KA
Timite
Marguerite
M
Blanche
Stephane
S
Msellati
Philippe
P
D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D007560:Cote d'Ivoire; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010349:Patient Compliance; D012367:RNA, Viral / Q000032:analysis; D016019:Survival Analysis; D019562:Viral Load
D012367:RNA, Viral