title: Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period.
abstract: BACKGROUND
  Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown.
  
  
  METHODS
  Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis.
  
  
  RESULTS
  Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p < 0.0001). Significant change in the use of each antiretroviral drug occurred over the time periods (p < 0.0001). Factors independently associated with virological and immunological success were as follows: later calendar periods, younger age at regimen (only for virological success) and higher CD4(+) T-lymphocyte percentage at baseline. Use of unboosted PI was associated with lower adjusted hazard ratio (aHR) of virological or immunological success with respect to NNRTI- and boosted PI-based regimens, with no difference among these two latter types.
  
  
  CONCLUSIONS
  Use of new generation antiretroviral drugs in Italian HIV-infected children is increasing. No different viro-immunological outcomes between NNRTI- and boosted PI-based cART were observed.
authors.affiliation: Department of Science for Woman and Child Health, University of Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
authors.forename: Clara
authors.initials: C
authors.lastname: Gabiano
authors.forename: Catiuscia
authors.initials: C
authors.lastname: Lisi
authors.forename: Vania
authors.initials: V
authors.lastname: Giacomet
authors.forename: Stefania
authors.initials: S
authors.lastname: Bernardi
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Raffaella
authors.initials: R
authors.lastname: Rosso
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.forename: Raffaele
authors.initials: R
authors.lastname: Badolato
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
authors.forename: Anna
authors.initials: A
authors.lastname: Maccabruni
authors.forename: Massimo
authors.initials: M
authors.lastname: Masi
authors.forename: Monica
authors.initials: M
authors.lastname: Cellini
authors.forename: Filippo
authors.initials: F
authors.lastname: Salvini
authors.forename: Cesare
authors.initials: C
authors.lastname: Di Bari
authors.forename: Maurizio
authors.initials: M
authors.lastname: Dedoni
authors.forename: Icilio
authors.initials: I
authors.lastname: Dodi
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D000293:Adolescent; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data / Q000639:trends; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors