[Effectiveness of antiretroviral therapy in HIV-1 infected children. A cross-sectional study].
BACKGROUND
There are few cross-sectional studies describing the current situation of HIV-1-infected children. Such studies would be useful to determine patients' clinical and immunologic and virologic status, currently prescribed therapies and their associated toxicity.


OBJECTIVE
To perform a descriptive analysis of the clinical, immunological and virological status of HIV-1-infected children followed-up in the pediatric unit of a tertiary hospital and describe the current antiretroviral therapies used to treat them.


METHODS
A cross-sectional study was performed. Data were collected from all HIV-1-infected children followed-up until January 2002 in a large pediatric referral hospital (Hospital 12 de Octubre in Madrid). Clinical evaluation and laboratory investigations were scheduled to be performed every 3 months. The most recent CD4 and plasma viral loads were evaluated. Viral loads were considered undetectable when there were less than 300 copies/ml at the last evaluation.


RESULTS
Sixty-six HIV-1-infected children who were followed-up to January 2002 were analyzed. All the children acquired the infection through vertical transmission except one, in whom the mode of transmission was unknown. The median age was 111 months (18-216). Twenty children were category C. The median CD4 cell count was 953 cells/mm3 (276-3137), 28 % +/- 8 (12.42). One child was receiving no therapy, four were on combination therapy with two nucleoside reverse transcriptase inhibitors (NRTI) and 61 were receiving highly active anti-retroviral therapy (HAART). Twenty-seven children (44 %) were receiving the first HAART regimen, 23 the second, and 11 had already been switched more than twice. Overall, 37 of the 61 patients receiving HAART had an undetectable plasma viral load.


CONCLUSIONS
Most children in our study had gone through several antiretroviral regimens, although not all children were being treated with HAART. Fifty-six percent of the patients with HAART had an undetectable plasma viral load. However, new complications associated with this therapy have begun to appear.
González Tomé
María I
MI
Servicio de Inmunodeficiencias, Hospital 12 de Octubre, Madrid, Spain. maribelgt@hotmail.com
Ramos Amador
J T
JT
Sánchez Granados
J M
JM
Guillén
S
S
Rojo
P
P
Ruiz Contreras
J
J
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male
D044966:Anti-Retroviral Agents