title: Feasibility and effectiveness of early initiation of combination antiretroviral therapy in HIV-infected infants in a government clinic of Kwazulu-Natal, South Africa.
abstract: A recent randomized trial showed dramatic improvement in survival of HIV-infected infants receiving early combination antiretroviral therapy (cART). However, few data are available for resource-limited settings. Therefore we conducted a chart review of HIV-infected infants initiated on cART between 2005 and 2008. Of 129 treated infants, 94 completed 6 months, 62 completed 12 months, and 39 completed 18 months of cART. Median age at initiation of cART was 8.6 months (range 2.1-11.9) and 77.2% had advanced disease. Undetectable VL was found in 78.8% of children who reached 18 months of treatment. CD4% increased from a median of 15.4% at baseline to 33.1% at 18 months. Weight for age Z-score increased from a mean ± SD of -2.7 ± 1.97 to 0.02 ± 1.10 at 18 months. Findings show favourable response to cART in HIV-infected infants outside a research environment, despite initial advanced disease. Efforts should be made to initiate cART as early as possible.
authors.affiliation: Department of Paediatrics, Pietermarizburg Metropolitan Hospitals Complex, Pietermaritzburg, 3200, South Africa.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Purchase
authors.forename: Dimitri J
authors.initials: DJ
authors.lastname: Van der Linden
authors.forename: Neil H
authors.initials: NH
authors.lastname: McKerrow
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013019:South Africa; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents