The prognosis of pediatric AIDS in serbia.
To determine the outcome of HIV infection in children in a resource-limited setting, a retrospective analysis of a series of 51 pediatric cases from the Serbian cohort of HIV infected patients was performed. Twenty seven patients died in the pre-HAART era, but mono/dual antiretroviral treatment had significantly (p=0.046) prolonged survival. Of the total of 24 HAART-treated patients, 10 had clinical AIDS before HAART initiation. The mean baseline CD4 cell count was 193.9 +/- 170.0/mm(3). After a mean follow-up of 72.6 +/- 44 months, a favorable response was recorded in 62.5%, treatment failure (defined as non-achievement of undetectable viremia) in 20.8%, and a discrepant virological and immunological response (achievement of undetectable viremia but without a rise in CD4 cell counts adequate for age) in 16.7% patients. No patients died, and there were only three hospital admissions after commencing HAART. Five immune restoration inflammatory syndrome episodes were recorded, of which four were due to BCG-osis. Lipodystrophy and hyperlipidemia occurred in 18.2% and 26.3% patients, respectively. We conclude that even in suboptimal facilities, the prognosis of HIV disease among children on HAART may be rather good. The metabolic syndrome seems to emerge as an important issue among long-term surviving children on HAART.
Jevtović
Djordje
D
Institute for Medical Research, University of Belgrade, Serbia.
Salemović
Dubravka
D
Ranin
Jovan
J
Brmbolić
Branko
B
Djurković-Djaković
Olgica
O
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D055771:Serbia; D016896:Treatment Outcome; D014766:Viremia / Q000188:drug therapy; D055815:Young Adult
D019380:Anti-HIV Agents