Antiretroviral therapy outcomes of HIV-infected children in the TREAT Asia pediatric HIV observational database.
BACKGROUND
We report responses to combination antiretroviral therapy (cART) in the Therapeutics Research, Education, and AIDS Training in Asia Pediatric HIV Observational Database.


METHODS
Children included were those who had received cART (ie, ≥3 antiretrovirals) at <18 years. The analysis was intention-to-treat by the first cART regimen. Median values are provided with interquartile ranges; hazard ratios (HRs) with 95% confidence intervals.


RESULTS
Of the 1655 children included, 50.4% were male, with a median age at cART of 7.0 (3.9-9.8) years and CD4 of 8% (2.0%-15%); 92.5% were started on an NNRTI; median duration of follow-up was 2.9 (1.4-4.6) years. Loss-to-follow-up and death rates were 4.2 (3.7-4.8) and 2.1 (1.7-2.5) per 100 person-years, respectively. At 36 months, median CD4 was 26% (21%-31%); 81% of those with viral load (n = 302) were <400 copies per milliliter. Children who reached CD4 ≥25% within 5 years were more likely to be females (HR: 1.4; 1.2-1.7), start before 18 months old (HR: 3.8; 2.4-6.2), lack a history of monotherapy/dual therapy (HR: 1.7; 1.4-2.5), and have a higher baseline CD4 (per 10% increase: HR: 2; 1.9-2.2).


CONCLUSIONS
These data underscore the need for early diagnosis and cART initiation to preserve immune function.
Hansudewechakul
Rawiwan
R
Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Sirisanthana
Virat
V
Kurniati
Nia
N
Puthanakit
Thanyawee
T
Lumbiganon
Pagakrong
P
Saphonn
Vonthanak
V
Yusoff
Nik Khairulddin Nik
NK
Kumarasamy
Nagalingeswaran
N
Fong
Siew Moy
SM
Nallusamy
Revathy
R
Srasuebkul
Preeyaporn
P
Law
Matthew
M
Sohn
Annette H
AH
Chokephaibulkit
Kulkanya
K
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001208:Asia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
D044966:Anti-Retroviral Agents