Long-term effectiveness of highly active antiretroviral therapy (HAART) in perinatally HIV-infected children in Denmark.
The long-term impact of highly active antiretroviral therapy (HAART) on HIV-1 infected children is not well known. The Danish Paediatric HIV Cohort Study includes all patients <16 y of age with HIV-1 infection in Denmark. We report the complete follow-up from 1996 to 2005 of 49 perinatally infected children treated with HAART. Initial HAART included 2 nucleoside reverse-transcriptase inhibitors in combination with either a protease inhibitor (n =38) or a non-nucleoside reverse-transcriptase inhibitor (n =12). 19 (39%) patients were previously treated with mono- or dual therapy. Baseline characteristics were median CD4 percentage 14% and HIV-RNA viral load 4.9 log(10). Within the first 12 weeks of therapy approximately 60% achieved HIV-RNA viral load <500 copies/ml, and this remained stable for up to 8 y, although many children changed the components of HAART. The proportion of children with CD4 percentage >25% increased to 60-70% over the y of treatment. For the total cohort, 245 patient-y of observation were available with only 1 death. During our observation period there were no signs of a waning impact. The challenge remains to maintain a high adherence to therapy as the children grow into adolescence and develop more independence from family and health care staff.
Bracher
Linda
L
Department of Paediatrics, Copenhagen University Hospital, Hvidovre, Denmark.
Valerius
Niels Henrik
NH
Rosenfeldt
Vibeke
V
Herlin
Troels
T
Fisker
Niels
N
Nielsen
Henrik
H
Obel
Niels
N
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000254:growth & development*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors