Response to antiretroviral therapy in HIV-infected Ugandan children exposed and not exposed to single-dose nevirapine at birth.
OBJECTIVE
To compare the response to a nevirapine (NVP)-based highly active antiretroviral therapy (HAART) in HIV-infected Ugandan children, exposed and nonexposed to single-dose NVP (sd NVP) at birth.


METHODS
HIV-infected study children were initiated on stavudine/lamivudine/NVP as a fixed dose combination. CD4 cell percent and HIV-1 RNA were documented at baseline, 12, 24, 36, and 48 weeks post-initiation of HAART.


RESULTS
Ninety-two children were enrolled in the study, 44 in the sd NVP-exposed and 48 in the nonexposed cohort. The median age at enrollment was 1.7 years [interquartile range (IQR) 1.2-2.4] and 7.8 years (IQR 5.9-9.2) in the sd NVP-exposed and nonexposed cohorts,respectively (P < 0.001). At baseline and week 48 post-HAART, the median CD4 cell percentages were 14% and 33% for the NVP-exposed group and 8% and 22.5% in the nonexposed group (P < 0.0001). The median (IQR) viral load at baseline was 650,568 (359,979-2,086,613) RNA copies/mL and 239,027 (105,904-494,813) RNA copies/mL in the NVP-exposed and nonexposed cohorts, respectively. After 48 weeks of HAART, 76% of the NVP-exposed and 80% of the nonexposed children had a median viral load of < 400 copies/mL (P = 0.74).


CONCLUSIONS
Both HIV-infected Ugandan older infants and children that were exposed and not exposed to sd NVP at birth had favorable treatment outcomes on NVP-containing HAART.
Musoke
Philippa M
PM
Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda. pmusoke@mujhu.org
Barlow-Mosha
Linda
L
Bagenda
Danstan
D
Mudiope
Peter
P
Mubiru
Michael
M
Ajuna
Patrick
P
Tumwine
James K
JK
Fowler
Mary Glenn
MG
D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male; D019829:Nevirapine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014454:Uganda
D019380:Anti-HIV Agents; D019829:Nevirapine